Objective To verify whether the area of the ONSAS (ONSASA) obtained by transorbital ultrasonography can be used to accurately evaluate the intracranial pressure (ICP).
Methods The recorded indexes included the optic nerve diameter, the optic nerve sheath diameter (ONSD), the width of both sides of the ONSAS (ONSASW) at 3 mm from the optic nerve head and the entire ONSASA outlined between 3 and 7 mm. After exploring and comparing five models to describe the relationship between body mass index (BMI), mean arterial blood pressure (MABP), ONSASA and ICP, the best model was determined.
Results In all, 90 patients with neurological diseases undergoing continuous invasive ICP monitoring were included in the study. In the training group, the correlation coefficient for the association between the ICP and ONSASA (Pearson’s correlation r=0.953) was higher than that for the association of the ICP with the ONSD (r=0.672; p<0.0001) and ONSASW at 3 mm behind the globe (r=0.691; p<0.0001). In the training group, the weighting function for prediction of the ICP was as follows: non-invasive ICP=2.050×ONSASA−0.051×BMI +0.036*MABP−5.837. With 20 mm Hg as the cut-off point for a high or low ICP, the sensitivity and specificity of ONSASA predicting ICP was 1.00 and 0.92. Receiver operator curve analysis revealed that the calculated cut-off value for predicting elevated ICP was 19.96 (area under curve= 0.960, 95% CI 0.865 to 1.00).
Conclusion Measurement of the ONSASA using ultrasonography can serve as a practical method for rapid and non-invasive quantification for evaluating ICP through an accurate mathematical formula with the BMI and MABP considered as contributing parameters.
Trial registration number The study was registered in the Chinese Clinical Trial Registry (Study no ChiCTR2100045274).
- Optic Nerve
Data availability statement
No data are available. Not available.
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YZ and KC contributed equally.
Correction notice The second affiliation has been updated since this article was first published.
Contributors YZ and KC contributed equally to this work. YZ, KC, HL, NinglW and NingW contributed to the conception and design. NingW, XQ, RP, YZ, KC, Kang Jun and HL performed the experiments, analysed data and wrote the manuscript. NinglW, XQ and RP participated in the collection of patient characteristics. HL is responsible for the overall content as the guarantor. All authors read and approved the final manuscript.
Funding This work was supported by Beijing Nova program (Z191100001119072) and National Natural Science Foundation of China (82171051).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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