Ertl M, Barinka F, Torka E, Altmann M, Pfister K, Helbig H, Bogdahn U, Gamulescu M A, Schlachetzki F
Department of Neurology, Bezirksklinikum Regensburg, University of Regensburg.
Department of Opthalmology, University of Regensburg.
Ultraschall Med. 2014 Oct;35(5):422-31. doi: 10.1055/s-0034-1366113. Epub 2014 Mar 19.
Ocular color-coded duplex sonography (OCCS), when performed within the safety limits of diagnostic ultrasonography, is an easy noninvasive technique with high potential for diagnosis and therapy in diseases with raised intracranial pressure and vascular diseases affecting the eye. Despite the capabilities of modern ultrasound systems and its scientific validation, OCCS has not gained widespread use in neurological practice. In this review, the authors describe the technique and main parameter settings of OCCS systems to reduce potential risks as thermal or cavitational effects for sensitive orbital structures. Applications of OCCS are the determination of intracranial pressure in emergency medicine, and follow-up evaluations of idiopathic intracranial hypertension and ventricular shunting by measuring the optic nerve sheath diameter. A diameter of 5.7 - 6.0 mm corresponds well with symptomatically increased intracranial pressure (> 20 cmH2O). OCCS also helps to discriminate between different etiologies of central retinal artery occlusion - by visualization of a "spot sign" and Doppler flow analysis of the central retinal artery - and aids the differential diagnosis of papilledema. At the end perspectives are illustrated that combine established ultrasound methods such as transcranial color-coded sonography with OCCS.
眼部彩色编码双功超声检查（OCCS）在诊断超声检查的安全范围内进行时，是一种简单的非侵入性技术，在颅内压升高的疾病和影响眼睛的血管疾病的诊断和治疗方面具有很高的潜力。尽管现代超声系统功能强大且经过科学验证，但OCCS在神经科实践中尚未得到广泛应用。在这篇综述中，作者描述了OCCS系统的技术和主要参数设置，以降低对敏感眼眶结构产生热效应或空化效应等潜在风险。OCCS的应用包括在急诊医学中测定颅内压，以及通过测量视神经鞘直径对特发性颅内高压和脑室分流进行随访评估。直径5.7 - 6.0毫米与有症状的颅内压升高（>20厘米水柱）高度相关。OCCS还有助于区分视网膜中央动脉阻塞的不同病因——通过观察“斑点征”和对视网膜中央动脉进行多普勒血流分析——并辅助视乳头水肿的鉴别诊断。最后阐述了将经颅彩色编码超声等既定超声方法与OCCS相结合的前景。
