Johnson Garrett G R J, Jelic Tomislav, Derksen Angela, Unger Bertram, Zeiler Frederick A, Ziesmann Markus T, Gillman Lawrence M
Department of Surgery, University of Manitoba, Winnipeg, MB, Canada.
Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada.
Front Med (Lausanne). 2022 Mar 2;9:831778. doi: 10.3389/fmed.2022.831778. eCollection 2022.
Transorbital sonographic measurement of optic nerve sheath diameter (ONSD) is an emerging non-invasive technique for the identification and monitoring of intracranial hypertension. In recent years, new pocket ultrasound devices have become available, and it is uncertain if they have the resolution to measure such small structures appropriately as compared to their predecessors. In this study, we measure the performance of three ultrasound units on a simulation model to establish their precision and accuracy.
ONSD was measured by three expert point-of-care sonographers using ultrasound machines three times on each of seven discrete ONS model sizes ranging from 3.5 to 7.9 mm. Two pocket ultrasounds (IVIZ, Sonosite, and Lumify, Philips) and one standard-sized portable ultrasound (M-Turbo, Sonosite) were used. Measurements were analyzed for mean error and variance and tested for significance using blocked covariance matrix regression analyses.
The devices differed in their variances (Lumify: 0.19 mm, M-Turbo: 0.26 mm, IVIZ: 0.34 mm) and their mean error (Lumify: -0.05 mm, M-Turbo: 0.10 mm, IVIZ: -0.10 mm). The difference in mean error between users is not significant ( = 0.45), but there is a significant difference in mean error between devices ( = 0.02).
Accurate ONSD measurement is possible utilizing pocket-sized ultrasound, and in some cases, may be more accurate than larger portable ultrasound units. While the differences in these devices were statistically significant, all three were highly accurate, with one pocket device (Lumify) outperforming the rest. Further study in human subjects should be conducted prior to using pocket ultrasound devices for diagnosis of intracranial hypertension.
经眼眶超声测量视神经鞘直径（ONSD）是一种用于识别和监测颅内高压的新兴非侵入性技术。近年来，新型袖珍超声设备已面市，但与前代产品相比，它们是否具备适当测量如此微小结构的分辨率尚不确定。在本研究中，我们在模拟模型上测量了三款超声设备的性能，以确定其精度和准确性。
由三位专业床旁超声检查医师使用超声仪，对七种离散的ON模型尺寸（范围为3.5至7.9毫米）各进行三次ONSD测量。使用了两款袖珍超声（IVIZ、索诺声和Lumify，飞利浦）和一款标准尺寸的便携式超声（M-Turbo，索诺声）。对测量结果进行平均误差和方差分析，并使用分组协方差矩阵回归分析检验其显著性。
这些设备在方差（Lumify：0.19毫米，M-Turbo：0.26毫米，IVIZ：0.34毫米）和平均误差（Lumify：-0.05毫米，M-Turbo：0.10毫米，IVIZ：-0.10毫米）方面存在差异。使用者之间平均误差的差异不显著（=0.45），但设备之间平均误差存在显著差异（=0.02）。
使用袖珍型超声可以准确测量ONSD，在某些情况下，可能比大型便携式超声设备更准确。虽然这些设备之间的差异具有统计学意义，但三款设备的准确性都很高，其中一款袖珍设备（Lumify）表现优于其他设备。在将袖珍超声设备用于颅内高压诊断之前，应进一步开展人体研究。
