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特发性颅内高压的视神经超声参数:病例对照研究

Optic nerve sonographic parameters in idiopathic intracranial hypertension, case-control study.

作者信息

Malky Islam El, Aita Wael Elshazly, Elkordy Alaa, Nasreldeen Marwa, Abdelhafiz Mahmoud, Tael Amr M, Abdelkhalek Hazem Mo

机构信息

Department of Neurology, Director of Interventional Neurovascular Unit, South Valley University, Qena, Egypt.

MD Ophthalmology, Department of Ophthalmology, South Valley University, Qena, Egypt.

出版信息

Sci Rep. 2025 Jan 13;15(1):1788. doi: 10.1038/s41598-024-85033-4.

Abstract

The most common diagnostic error of IIH is inaccurate funduscopic examination. Moreover, IIH could be diagnosed without papilledema. Trans orbital sonography could be used as a non-invasive and cheap tool for discovering increased ICP (intracranial Pressure). Aim of our study was discovering the changes in ultra-sonographic indices and which one could predict the increased ICP. Sixty-eight patients were diagnosed as definite IIH and 68 healthy volunteers are included in the study who had the same sex and age. ONSD, peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were estimated by transorbital color Doppler. Multivariate linear regression was used to discover the predictors of increased ICP. ROC curve was plotted for the predictor. A statistically significant difference was found between IIH patients and controls regarding ONSD, EDV and RI. Multivariate linear regression revealed that ONSD is the only predictor of increased CSP pressure. Its cut-off value indicating high ICP was 5.7 mm on Rt and Lt eye (AUC: 0.916; 95% confidence interval 0.867-0.965; p < 0.001; 90% sensitivity, 80% specificity at Rt eye. AUC: 0.902; 95% confidence interval 0.845-0.958; p < 0.001; 91% sensitivity, 80% specificity at Lt eye).

摘要

特发性颅内高压最常见的诊断错误是眼底检查不准确。此外,特发性颅内高压在没有视乳头水肿的情况下也可能被诊断出来。经眶超声检查可作为一种无创且廉价的工具来发现颅内压升高。我们研究的目的是发现超声指标的变化以及哪一项指标可以预测颅内压升高。68例患者被确诊为明确的特发性颅内高压,68名年龄和性别相同的健康志愿者被纳入研究。通过经眶彩色多普勒估计视神经鞘直径(ONSD)、收缩期峰值流速(PSV)、舒张末期流速(EDV)和阻力指数(RI)。采用多元线性回归来发现颅内压升高的预测因素。为该预测因素绘制ROC曲线。在ONSD、EDV和RI方面,特发性颅内高压患者与对照组之间存在统计学显著差异。多元线性回归显示,ONSD是脑脊液压力升高的唯一预测因素。其提示颅内压升高的临界值在右眼和左眼均为5.7毫米(曲线下面积:0.916;95%置信区间0.867 - 0.965;p < 0.001;右眼敏感度90%,特异度80%。曲线下面积:0.902;95%置信区间0.845 - 0.958;p < 0.001;左眼敏感度91%,特异度80%)。

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