Evaluation Value of Ultrasonic Measurement of Optic Nerve Sheath Diameter and Central Retinal Artery in Intracranial Hypertension Caused by Traumatic Injury in Children
Objective:To investigate the diagnostic value of ultrasonic measurement of optic nerve sheath diameter(ONSD)and central retinal artery(CRA)blood flow parameters for intracranial hypertension caused by traumatic injury in children.Method:A total of 59 children with intracranial pressure(ICP)≥15 mmHg after severe traumatic brain injury(TBI)surgery admitted to Xiamen Children's Hospital from July 2019 to December 2021 were selected as the experimental group,41 healthy children who underwent physical examination in our hospital at the same time served as the control group.The ONSD and blood flow parameters of CRA were measured by ultrasound.The difference of parameters between the experimental group and the control group were compared,and the efficacy of each parameter in diagnosing intracranial hypertension and the multi-parameter combination in diagnosing intracranial hypertension were analyzed by receiver operator characteristic(ROC)curve.Result:The bilateral ONSD of the experimental group were significantly larger than those of the control group,the differences were statistically significant(P<0.05).The bilateral end diastolic velocity(EDV)of the experimental group were smaller than those of the control group,the bilateral peak systolic velocity/EDV(S/D)of the experimental group were larger than those of the control group,and bilateral resistance index(RI)were higher than those of the control group,the differences were all statistically significant(P<0.05).ROC curve showed that the optimal critical value of ONSD for diagnosing intracranial hypertension was 4.9 mm,sensitivity was 83.05%,specificity was 92.68%,and AUC was 0.938.The optimal critical value of EDV for diagnosing intracranial hypertension was 3.48 cm/s,the sensitivity was 77.97%,the specificity was 60.98%,and the AUC was 0.719.The optimal critical value of S/D for diagnosing intracranial hypertension was 2.92,sensitivity was 67.80%,specificity was 85.40%,and AUC was 0.786.The optimal critical value of RI for diagnosing intracranial hypertension was 0.65,sensitivity was 72.88%,specificity was 82.93%,and AUC was 0.835.The sensitivity,specificity and AUC of RI and ONSD in the diagnosis of intracranial hypertension were 93.20%,78.05%and 0.955,respectively.Conclusion:The increase of intracranial pressure can be indirectly judged by ultrasonic measurement of ONSD and RI.The combination of ONSD and RI has high diagnostic efficiency and can be used as an effective evaluation method when continuous non-invasive monitoring is needed.
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