Ballantyne S A, O'Neill G, Hamilton R, Hollman A S
Department of Radiology and Clinical Physics, Royal Hospital for Sick Children, G46 7PD, Glasgow, UK.
Eur J Ultrasound. 2002 Oct;15(3):145-9. doi: 10.1016/s0929-8266(02)00036-8.
To quantify the observer variation in the sonographic measurement of optic nerve sheath diameter (ONSD) in normal adults.
Sixty-seven normal adult volunteers underwent ultrasound examination of each eye by three independent observers using a 7 MHz sector probe. Three measurements were made of each eye by each observer and a mean value calculated for each eye. Median and 5th-95th centile values for both intra- and inter-observer variation were calculated for the three observers.
The median intra-observer variation was +/-0.1 mm, with 5th-95th centile values of +/-0-0.4 mm. The median inter-observer variation was +/-0.2-0.3 mm, with 5th-95th centile values of +/-0-0.7 mm. Careful review of examination technique by the three observers after the first 17 examinations was shown to reduce both intra- and inter-observer variation.
The sonographic measurement of ONSD is a readily learned, reproducible technique with low intra- and inter-observer variation. The average inter-observer variation (+/-0.2 mm) is comparable to the inherent variability of the ultrasound machine. The importance of standardisation of examination technique is stressed.
量化正常成年人视神经鞘直径（ONSD）超声测量中的观察者间差异。
67名正常成年志愿者由三名独立观察者使用7MHz扇形探头对每只眼睛进行超声检查。每位观察者对每只眼睛进行三次测量，并计算每只眼睛的平均值。计算三名观察者的观察者内和观察者间差异的中位数以及第5 - 95百分位数。
观察者内差异的中位数为±0.1mm，第5 - 95百分位数为±0 - 0.4mm。观察者间差异的中位数为±0.2 - 0.3mm，第5 - 95百分位数为±0 - 0.7mm。在前17次检查后，三名观察者仔细回顾检查技术，结果显示观察者内和观察者间差异均有所减少。
ONSD的超声测量是一种易于掌握、可重复的技术，观察者内和观察者间差异较小。观察者间的平均差异（±0.2mm）与超声机器的固有变异性相当。强调了检查技术标准化的重要性。
