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Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging.

Bäuerle J, Schuchardt F, Schroeder L, Egger K, Weigel M, Harloff A - BMC Neurol (2013)

Bottom Line: Further analyses revealed good inter- and intra-observer reliability for sonographic measurements 3 mm behind the papilla and for MRI at 3 and 5 mm (r > 0.82, p < 0.001, mean differences < 5%).Sonographic ONSD quantification 3 mm behind the papilla can be performed with good reproducibility, measurement accuracy and observer agreement.Thus, our findings emphasize the feasibility of this technique as a non-invasive bedside tool for longitudinal ONSD measurements.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurology, University Medical Center Freiburg, Breisacher Str, 64, 79106 Freiburg, Germany. jochen.baeuerle@uniklinik-freiburg.de.

ABSTRACT

Background: Quantification of the optic nerve sheath diameter (ONSD) by transbulbar sonography is a promising non-invasive technique for the detection of altered intracranial pressure. In order to establish this method as follow-up tool in diseases with intracranial hyper- or hypotension scan-rescan reproducibility and accuracy need to be systematically investigated.

Methods: The right ONSD of 15 healthy volunteers (mean age 24.5 ± 0.8 years) were measured by both transbulbar sonography (9 - 3 MHz) and 3 Tesla MRI (half-Fourier acquisition single-shot turbo spin-echo sequences, HASTE) 3 and 5 mm behind papilla. All volunteers underwent repeated ultrasound and MRI examinations in order to assess scan-rescan reproducibility and accuracy. Moreover, inter- and intra-observer variabilities were calculated for both techniques.

Results: Scan-rescan reproducibility was robust for ONSD quantification by sonography and MRI at both depths (r > 0.75, p ≤ 0.001, mean differences < 2%). Comparing ultrasound- and MRI-derived ONSD values, we found acceptable agreement between both methods for measurements at a depth of 3 mm (r = 0.72, p = 0.002, mean difference < 5%). Further analyses revealed good inter- and intra-observer reliability for sonographic measurements 3 mm behind the papilla and for MRI at 3 and 5 mm (r > 0.82, p < 0.001, mean differences < 5%).

Conclusions: Sonographic ONSD quantification 3 mm behind the papilla can be performed with good reproducibility, measurement accuracy and observer agreement. Thus, our findings emphasize the feasibility of this technique as a non-invasive bedside tool for longitudinal ONSD measurements.

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Reproducibility and accuracy of ONSD assessment. Bland-Altman plots displaying the agreement of scan-rescan measurements of the optic nerve sheath diameter (ONSD) 3 mm behind the papilla by transorbital sonography (A) and MRI (B). Panel C demonstrates the agreement between sonographic and MRI-based ONSD quantification at the first visit. Continuous lines depict the mean of differences; dashed lines denote limits of agreement (mean ± 1.96 times of standard deviation).
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Figure 2: Reproducibility and accuracy of ONSD assessment. Bland-Altman plots displaying the agreement of scan-rescan measurements of the optic nerve sheath diameter (ONSD) 3 mm behind the papilla by transorbital sonography (A) and MRI (B). Panel C demonstrates the agreement between sonographic and MRI-based ONSD quantification at the first visit. Continuous lines depict the mean of differences; dashed lines denote limits of agreement (mean ± 1.96 times of standard deviation).

Mentions: As summarized in Table 1, ONSD quantification by transbulbar sonography and MRI 3 mm behind the papilla demonstrated good reproducibility (r > 0.75, p < 0.001) with mean differences of < 2% of average ONSD values (Figure 2). If measurements were performed 5 mm behind the papilla Bland-Altman analyses revealed similar results.


Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging.

Bäuerle J, Schuchardt F, Schroeder L, Egger K, Weigel M, Harloff A - BMC Neurol (2013)

Reproducibility and accuracy of ONSD assessment. Bland-Altman plots displaying the agreement of scan-rescan measurements of the optic nerve sheath diameter (ONSD) 3 mm behind the papilla by transorbital sonography (A) and MRI (B). Panel C demonstrates the agreement between sonographic and MRI-based ONSD quantification at the first visit. Continuous lines depict the mean of differences; dashed lines denote limits of agreement (mean ± 1.96 times of standard deviation).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219451&req=5

Figure 2: Reproducibility and accuracy of ONSD assessment. Bland-Altman plots displaying the agreement of scan-rescan measurements of the optic nerve sheath diameter (ONSD) 3 mm behind the papilla by transorbital sonography (A) and MRI (B). Panel C demonstrates the agreement between sonographic and MRI-based ONSD quantification at the first visit. Continuous lines depict the mean of differences; dashed lines denote limits of agreement (mean ± 1.96 times of standard deviation).
Mentions: As summarized in Table 1, ONSD quantification by transbulbar sonography and MRI 3 mm behind the papilla demonstrated good reproducibility (r > 0.75, p < 0.001) with mean differences of < 2% of average ONSD values (Figure 2). If measurements were performed 5 mm behind the papilla Bland-Altman analyses revealed similar results.

Bottom Line: Further analyses revealed good inter- and intra-observer reliability for sonographic measurements 3 mm behind the papilla and for MRI at 3 and 5 mm (r > 0.82, p < 0.001, mean differences < 5%).Sonographic ONSD quantification 3 mm behind the papilla can be performed with good reproducibility, measurement accuracy and observer agreement.Thus, our findings emphasize the feasibility of this technique as a non-invasive bedside tool for longitudinal ONSD measurements.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurology, University Medical Center Freiburg, Breisacher Str, 64, 79106 Freiburg, Germany. jochen.baeuerle@uniklinik-freiburg.de.

ABSTRACT

Background: Quantification of the optic nerve sheath diameter (ONSD) by transbulbar sonography is a promising non-invasive technique for the detection of altered intracranial pressure. In order to establish this method as follow-up tool in diseases with intracranial hyper- or hypotension scan-rescan reproducibility and accuracy need to be systematically investigated.

Methods: The right ONSD of 15 healthy volunteers (mean age 24.5 ± 0.8 years) were measured by both transbulbar sonography (9 - 3 MHz) and 3 Tesla MRI (half-Fourier acquisition single-shot turbo spin-echo sequences, HASTE) 3 and 5 mm behind papilla. All volunteers underwent repeated ultrasound and MRI examinations in order to assess scan-rescan reproducibility and accuracy. Moreover, inter- and intra-observer variabilities were calculated for both techniques.

Results: Scan-rescan reproducibility was robust for ONSD quantification by sonography and MRI at both depths (r > 0.75, p ≤ 0.001, mean differences < 2%). Comparing ultrasound- and MRI-derived ONSD values, we found acceptable agreement between both methods for measurements at a depth of 3 mm (r = 0.72, p = 0.002, mean difference < 5%). Further analyses revealed good inter- and intra-observer reliability for sonographic measurements 3 mm behind the papilla and for MRI at 3 and 5 mm (r > 0.82, p < 0.001, mean differences < 5%).

Conclusions: Sonographic ONSD quantification 3 mm behind the papilla can be performed with good reproducibility, measurement accuracy and observer agreement. Thus, our findings emphasize the feasibility of this technique as a non-invasive bedside tool for longitudinal ONSD measurements.

Show MeSH
Related in: MedlinePlus