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儿童视神经超声评估:综述

Optic Nerve Ultrasound Evaluation in Children: A Review.

作者信息

Abbinante Giulia, Vitiello Livio, Coppola Alessia, Salerno Giulio, Gagliardi Vincenzo, Pellegrino Alfonso

机构信息

Eye Unit, "Luigi Curto" Hospital, Azienda Sanitaria Locale Salerno, Polla, 84035 Salerno, Italy.

出版信息

Diagnostics (Basel). 2023 Feb 1;13(3):535. doi: 10.3390/diagnostics13030535.

Abstract

Managing patients with neurocritical illness requires monitoring and treating elevated intracranial pressure (ICP), especially in cases in children. In terms of precise and real-time measurements, invasive ICP measurements are presently the gold standard for the initial diagnosis and follow-up ICP assessments. As a rapid and non-invasive way to detect elevated ICP, point-of-care ultrasonography (POCUS) of optic nerve sheath diameter (ONSD) has been proposed. The utility of bedside POCUS of ONSD to detect elevated ICP with excellent diagnostic test accuracy in adults has already been demonstrated. Nonetheless, data on the relationship between POCUS of ONSD and ICP in children are scarce. Therefore, the purpose of this review is to point out the most recent findings from the pediatric published literature and briefly discuss what was assessed with ONSD ultrasound examination, and also to describe and discuss the diagnostic procedures available for optic nerve ultrasound appraisal. A search of the medical databases PubMed and Scopus was carried out. The terms such as "ocular ultrasonography", "ICP assessment", "children", "point-of-care ultrasound", and "POCUS" were searched. In conclusion, the use of the standardized A-scan technique coupled with the B-scan technique should be suggested to provide data that are as accurate, precise, repeatable, and objective as possible.

摘要

管理患有神经危重症的患者需要监测和治疗颅内压(ICP)升高的情况,尤其是儿童患者。就精确和实时测量而言,有创ICP测量目前是初始诊断和后续ICP评估的金标准。作为一种检测ICP升高的快速且无创的方法,已经有人提出了利用床旁即时超声检查(POCUS)测量视神经鞘直径(ONSD)。床旁POCUS测量ONSD在检测成人ICP升高方面具有出色的诊断测试准确性,这一点已经得到证实。尽管如此,关于儿童中ONSD的POCUS与ICP之间关系的数据却很稀少。因此,本综述的目的是指出儿科已发表文献中的最新发现,并简要讨论通过ONSD超声检查评估了哪些内容,同时描述和讨论可用于视神经超声评估的诊断程序。我们对医学数据库PubMed和Scopus进行了检索。检索了“眼部超声检查”、“ICP评估”、“儿童”、“床旁即时超声”和“POCUS”等术语。总之,建议采用标准化的A扫描技术结合B扫描技术,以提供尽可能准确、精确、可重复和客观的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3a5/9914511/42c83948b5d8/diagnostics-13-00535-g001.jpg

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