Chen Shun-Ping, Dong Yun, Ye Ling, Jiang Yi-Han, Jiang Zi-Pei, Xia Yong-Sheng
Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
National Key Clinical Specialty (Wound Healing), the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Quant Imaging Med Surg. 2025 May 1;15(5):4608-4615. doi: 10.21037/qims-2024-2760. Epub 2025 Apr 28.
Ultrasound (US) measurement of the optic nerve sheath diameter serves as a valuable adjunctive monitoring tool in acute care. However, the relationship between optic nerve stiffness assessed by shear wave elastography (SWE) and the presence of ipsilateral brain or eye lesions in patients with secondary headaches remains unclear. The aim of this study was to explore the association between optic nerve stiffness values and the presence of ipsilateral brain or eye lesions in patients with secondary headaches.
From January 2023 to April 2024, a retrospective study was conducted on 54 patients presenting with secondary headaches. Optic nerve sheath diameter and stiffness values were measured using grey-scale and SWE US, respectively. Optic nerves were categorized into 2 groups based on the presence or absence of ipsilateral brain or eye lesions: the target group (with ipsilateral lesions) and the contralateral group (without ipsilateral lesions). Comparisons of ultrasonographic parameters between these groups were performed.
A total of 18 patients (mean age: 52.28±11.78 years, 11 females; 36 optic nerves) participated in the study. No significant difference in optic nerve sheath diameter was observed between the two groups (P=0.353). In contrast, optic nerve stiffness measured by SWE was significantly higher in the target group compared to the contralateral group (P<0.001). The area under the receiver operating characteristic (ROC) curve (AUC) for SWE stiffness in predicting ipsilateral lesions was 0.861 [95% confidence interval (CI): 0.653-0.986, P<0.0001]. The application of an SWE stiffness threshold of 59.2 kPa for localizing ipsilateral lesions yielded a sensitivity of 88.89% (95% CI: 65.3-98.6%) and a specificity of 72.22% (95% CI: 46.5-90.3%).
Increased optic nerve stiffness correlates with the presence of ipsilateral brain or eye lesions in patients with secondary headaches. Optic nerve elastography can aid in localizing lesions in the brain or eye in patients with secondary headaches.
超声（US）测量视神经鞘直径是急性护理中一种有价值的辅助监测工具。然而，在继发性头痛患者中，通过剪切波弹性成像（SWE）评估的视神经硬度与同侧脑或眼病变的存在之间的关系仍不清楚。本研究的目的是探讨继发性头痛患者视神经硬度值与同侧脑或眼病变存在之间的关联。
2023年1月至2024年4月，对54例继发性头痛患者进行了一项回顾性研究。分别使用灰阶超声和SWE超声测量视神经鞘直径和硬度值。根据同侧脑或眼病变的有无，将视神经分为两组：目标组（有同侧病变）和对侧组（无同侧病变）。对两组之间的超声参数进行比较。
共有18例患者（平均年龄：52.28±11.78岁，11例女性；36条视神经）参与了研究。两组之间视神经鞘直径无显著差异（P=0.353）。相比之下，目标组通过SWE测量的视神经硬度显著高于对侧组（P<0.001）。SWE硬度预测同侧病变的受试者操作特征（ROC）曲线下面积（AUC）为0.861 [95%置信区间（CI）：0.653-0.986，P<0.0001]。应用59.2 kPa的SWE硬度阈值定位同侧病变，敏感性为88.89%（95%CI：65.3-98.6%），特异性为72.22%（95%CI：46.5-90.3%）。
继发性头痛患者视神经硬度增加与同侧脑或眼病变的存在相关。视神经弹性成像有助于定位继发性头痛患者脑或眼中的病变。
