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Article Abstract
Background: To develop and validate a multimodal transorbital ultrasound model for noninvasive detection of increased intracranial pressure (IICP) by integrating anatomical and hemodynamic parameters.
Methods: In this prospective diagnostic study, 136 neurology patients scheduled for lumbar puncture underwent pre-procedural ultrasound measurement of optic nerve sheath diameter (ONSD), ONSD-to-eyeball transverse diameter ratio (ONSD/ETD), and central retinal artery hemodynamics (peak systolic velocity [PSV], resistance index [RI]). Patients were classified as IICP (CSF pressure > 200 mmH₂O) or normal ICP (NICP) groups. Parameter performance was analyzed via ROC curves; multivariate logistic regression constructed a predictive model.
Results: The IICP group (n = 52) showed significantly higher ONSD (5.06 ± 0.49 vs. 4.19 ± 0.82 mm), ONSD/ETD (0.24 ± 0.02 vs.0.19 ± 0.04), and RI (0.66 ± 0.07vs.0.56 ± 0.09) but lower PSV (9.45 ± 1.38 vs.10.86 ± 2.14 cm/s) versus NICP (n = 84) (all P < 0.001). The integrated model (ONSD + ONSD/ETD + PSV + RI) achieved superior diagnostic accuracy: AUC 0.95 (95% CI: 0.922-0.988), sensitivity 88.1%, specificity 98.0%, Youden's index 0.86-significantly outperforming any single parameter (AUC 0.67-0.87, P < 0.001)-with the predictive equation: Logit(P) = 1.94×ONSD-84.6×ONSD/ETD + 0.79×PSV-3.8×RI + 11.05.
Conclusion: Transorbital multimodal ultrasound combining structural and vascular parameters enables highly accurate, rapid IICP screening, offering a clinically viable noninvasive alternative to conventional monitoring.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379483 | PMC |
| http://dx.doi.org/10.1186/s12880-025-01893-w | DOI Listing |
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