Article
Non-invasive ultrasound (US) assessment of intracranial pressure (ICP) and ventricular size as an ideal first-line and follow-up diagnostic tool in patients with hydrocephalus
Nicht-invasive Ultraschall (US) basierte Abschätzung von intrakraniellem Druck (ICP) und Ventrikelweite als ideale Erst- und Verlaufsdiagnostik bei Patienten mit Hydrocephalus
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Published: | June 4, 2021 |
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Objective: The aim of this project is to use non-invasive ultrasound technology to research essential and fundamental physiological and pathophysiological relationships between intracranial pressure, ventricular width and individual factors. Furthermore we aim to establish reliable, non-invasive examination methods for patients with hydrocephalus.
Methods: 239 children and 132 adult patients with hydrocephalus of different origin were included. Transorbital US measurement of the optic nerve sheath diameter (ONSD) was performed to assess ICP and transtemporal US measurement of the third ventricle diameter (TVD) provided insights into the ventricular system. US investigations were done initially, after therapy and repeatedly during the course of the disease and were correlated with MRI/CT findings, opthalmological, clinical and invasive ICP-parameters.
Results: In 81 patients, ONSD was compared to invasively measured ICP and correlated well (r= 0.65, p< 0.01). In 215 patients, ONSD and TVD values measured at initial diagnosis or at shunt failure, were increased (mean ONSD 5.9±0.6mm, mean TVD 7.86±5.86mm) and decreased significantly (p<0.001) after therapy (mean ONSD 5.2±0.4mm, mean TVD 4.86±4.57mm). Shunt or ETV failure led to significant and quick re-increase of both ONSD and TVD.
Conclusion: Transorbital US ONSD and transtemporal US TVD are an excellent, non-invasive first-line screening tool if hydrocephalus is suspected in any age-group and can be used to reliably follow-up hydrocephalus patients after therapy.