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J Korean Soc Emerg Med > Volume 30(2); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(2): 183-189.
두개내압 상승 평가에서 두부 전산화단층촬영과 초음파를 이용한 시신경초 직경 측정의 비교분석
성보연 , 홍대영 , 김신영, 김종원, 박상오, 이경룡, 백광제
건국대학교 의학전문대학원 응급의학교실
The comparison of optic nerve sheath diameter measured by computed tomography and ultrasonography in evaluating increased intracranial pressure
Bo Youn Sung , Dae Young Hong , Sin Young Kim, Jong Won Kim, Sang O Park, Kyeong Ryong Lee, Kwang Je Baek
Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
Correspondence  Dae Young Hong ,Tel: 02-2030-5790, Fax: 02-2030-5789, Email: sean1011@naver.com,
Received: August 19, 2018; Revised: August 19, 2018   Accepted: September 16, 2018.  Published online: April 30, 2019.
ABSTRACT
Objective:
While the optic nerve sheath diameter (ONSD) is measured by computed tomography and ultrasonography as an indicator of an elevation in the intracranial pressure (ICP), it is unclear which ONSD measurement is useful for predicting an increased ICP. This study examined the comparability between the ONSD measured by computed tomography and ultrasonography.
Method:
A prospective study of 150 patients in the emergency center was performed. The ONSD was measured 3 mm behind the globe of all patients by computed tomography and ultrasonography. The receiver operator characteristic (ROC) curve was analyzed to determine the diagnostic utility of detecting ICP through ONSD.
Results:
A total of 150 patients were enrolled. Thirty-three patients (22.0%) were found to have an increased ICP. The ONSD in patients with increased ICP was significantly higher than that of normal ICP patients measured by computed tomography and ultrasonography. Moreover, computed tomography and ultrasonography revealed an area under the ROC curve value of 0.886 and 0.933, respectively. The ONSD measurement by computed tomography and ultrasonography produced similar results (P=0.256).
Conclusion:
The ONSD measured by computed tomography and ultrasonography is a valuable indicator of an ICP elevation. Therefore, either of the two diagnostic methods for monitoring the ICP can be used in patients with a critical care and resource-limited setup.
Key words: Optic nerve; Computed tomography; Ultrasonography; Intracranial pressure
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