CT 测量视神经鞘直径在鉴别短暂性脑缺血发作和急性脑梗死中的作用。
The role of optic nerve sheath diameter measurement on CT in differentiating transient ischemic attack and acute ischemic stroke.
机构信息
Department of Emergency Medicine, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey.
Department of Radiology, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey; Department of Radiology, Beytepe Murat Erdi Eker State Hospital, Ankara, Turkey.
出版信息
Clin Neurol Neurosurg. 2022 Jan;212:107094. doi: 10.1016/j.clineuro.2021.107094. Epub 2021 Dec 16.
OBJECTIVE
This study aimed to determine if optic nerve sheath diameter (ONSD) measurement on computed tomography could differentiate transient ischemic attack (TIA) from acute ischemic stroke (AIS). Both TIA and AIS are the rings of the same disease chain. To exclude hemorrhagic stroke and stroke mimics in these patients, brain computed tomography (CT) remains the first step imaging modality.
PATIENTS AND METHODS
In this retrospective study, ONSDs of patients with TIA and AIS within three hours from symptom onset to initial CT was measured. The right, left, mean, and delta ONSD measurements were compared between AIS and TIA groups. Then diagnostic accuracy metrics were calculated.
RESULTS
A total of 196 patients (128 in the AIS group and 68 in the TIA group) were included. Both mean and delta ONSD of AIS patients were higher than those of the TIA group. The area under the receiver operating curve of mean and delta ONSD for predicting AIS were 0.746 with a sensitivity of 82.8% and a specificity of 42.7% (cut-off: 5.00 mm), and 0.826 with a sensitivity of 67.2% and a specificity of 86.8% (cut-off: 0.50 mm), respectively.
CONCLUSION
Increased mean or delta ONSD measured on initial CT could alert emergency physicians for an impending stroke.
目的
本研究旨在确定视神经鞘直径（ONSD）测量值在计算机断层扫描（CT）上是否可以区分短暂性脑缺血发作（TIA）和急性缺血性脑卒中（AIS）。TIA 和 AIS 均为同一疾病链的环节。为了排除这些患者的出血性中风和中风模拟，脑 CT（CT）仍然是第一步成像方式。
患者和方法
在这项回顾性研究中，测量了发病至初始 CT 三小时内 TIA 和 AIS 患者的 ONSD。比较了 AIS 和 TIA 组之间的右侧、左侧、平均和 ONSD 差值测量值。然后计算了诊断准确性指标。
结果
共纳入 196 例患者（AIS 组 128 例，TIA 组 68 例）。AIS 患者的平均和 ONSD 差值均高于 TIA 组。平均和 ONSD 预测 AIS 的受试者工作特征曲线下面积分别为 0.746，灵敏度为 82.8%，特异性为 42.7%（截断值：5.00mm）和 0.826，灵敏度为 67.2%，特异性为 86.8%（截断值：0.50mm）。
结论
在初始 CT 上测量的平均或 ONSD 差值增加可能会提醒急诊医生即将发生中风。
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