Li Jian, Wan Chao
Department of Radiology, the First Hospital of China Medical University, Shenyang, China.
Department of Ophthalmology, the First Hospital of China Medical University, Shenyang, China.
Quant Imaging Med Surg. 2021 Jun;11(6):2823-2836. doi: 10.21037/qims-20-1188.
Intracranial pressure (ICP) is associated with a variety of diseases. Early diagnosis and the timely intervention of elevated ICP are effective means to clinically reduce the morbidity and mortality of some diseases. The detection and judgment of reduced ICP are beneficial to glaucoma doctor and neuro ophthalmologist to diagnose optic nerve disease earlier. It is important to evaluate and monitor ICP clinically. Although invasive ICP detection is the gold standard, it can have complications. Most non-invasive ICP tests are related to the optic nerve and surrounding tissues due to their anatomical characteristics. Ultrasound, magnetic resonance imaging, transcranial Doppler, papilledema on optical coherence tomography, visual evoked potential, ophthalmodynamometry, the assessment of spontaneous retinal venous pulsations, and eye-tracking have potential for application. Although none of these methods can completely replace invasive technology; however, its repeatable, low risk, high accuracy, gradually attracted people's attention. This review summarizes the non-invasive ICP detection methods related to the optic nerve and the role of the diagnosis and prognosis of neurological disorders and glaucoma. We discuss the advantages and challenges and predict possible areas of development in the future.
颅内压(ICP)与多种疾病相关。早期诊断及对升高的颅内压进行及时干预是临床上降低某些疾病发病率和死亡率的有效手段。对降低的颅内压进行检测和判断有助于青光眼医生和神经眼科医生更早地诊断视神经疾病。临床上评估和监测颅内压很重要。虽然有创颅内压检测是金标准,但它可能会有并发症。由于其解剖学特征,大多数无创颅内压检测都与视神经及周围组织有关。超声、磁共振成像、经颅多普勒、光学相干断层扫描上的视乳头水肿、视觉诱发电位、眼动脉压测量、对视网膜静脉自发性搏动的评估以及眼动追踪都有应用潜力。虽然这些方法都不能完全取代有创技术;然而,其可重复、低风险、高精度,逐渐引起了人们的关注。本综述总结了与视神经相关的无创颅内压检测方法以及其在神经系统疾病和青光眼诊断及预后中的作用。我们讨论了其优点和挑战,并预测了未来可能的发展领域。