Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis

IntroductionIncreased intracranial pressure (ICP) is common with viral encephalitis in children which is associated with complications and prognosis. The optic nerve sheath diameter (ONSD) is a new indicator for the assessment of intracranial pressure using ultrasound, CT scan and MRI imaging. Given...

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Main Authors: Chun Zhao, Peng-Cheng Sun, Ke-Jie Fang, Hui-Hui Fu, Li-Feng Wei, Yin-Yun Miao, Xin-Xin Guo, Xiao-Ling Weng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2024.1485107/full
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author Chun Zhao
Peng-Cheng Sun
Ke-Jie Fang
Hui-Hui Fu
Li-Feng Wei
Yin-Yun Miao
Xin-Xin Guo
Xiao-Ling Weng
author_facet Chun Zhao
Peng-Cheng Sun
Ke-Jie Fang
Hui-Hui Fu
Li-Feng Wei
Yin-Yun Miao
Xin-Xin Guo
Xiao-Ling Weng
author_sort Chun Zhao
collection DOAJ
description IntroductionIncreased intracranial pressure (ICP) is common with viral encephalitis in children which is associated with complications and prognosis. The optic nerve sheath diameter (ONSD) is a new indicator for the assessment of intracranial pressure using ultrasound, CT scan and MRI imaging. Given the influence of physical development on ONSD size in children, we expect more accurate assessment of intracranial pressure with ONSD/ETD (eyeball transverse diameter) ratio by ultrasound. The aim of the study is to determine the performance of the ONSD/ETD ratio measurement to predict ICP occurring in children with viral encephalitis and evaluate the therapeutic effect.MethodsChildren with viral encephalitis from May 2022 to June 2024 were recruited in this study. The initial ONSD/ETD ratio measurement by ultrasound were completed before lumbar puncture. Children were divided into the increased ICP group and the normal ICP group based on whether the ICP was over 200 mmH2O measured by lumbar puncture. The ultrasound was repeated on the 3rd and 7th day of treatment.ResultsThe ONSD/ETD ratios measured in the two groups before treatment were 0.231 ± 0.019 and 0.182 ± 0.012, respectively (p < 0.01). The ONSD/ETD ratio on the 3rd day of treatment in the increased ICP group was significantly lower than the data before treatment (p < 0.01). The data on the 7th day of treatment in increased ICP group was significantly lower than the data before treatment (p < 0.01), but not statistically significant compared to the data on the 3rd day of treatment (p = 0.650). The ROC curve demonstrated an AUC for ONSD/ETD ratio in predicting the occurrence of increased ICP in children with viral encephalitis was 0.974 [95% confidence interval (CI): 0.939–1.000, p < 0.01], with a sensitivity of 95.1% and specificity of 93.3% at a cut-off value of 0.198.ConclusionOur study shows that ONSD/ETD can be used as an easy reference tool for evaluating ICP in children with viral encephalitis which can reflect the therapeutic effect.
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spelling doaj-art-57abab05fb75490f8188f6aa1d21e99d2025-01-07T06:45:29ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011210.3389/fped.2024.14851071485107Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitisChun Zhao0Peng-Cheng Sun1Ke-Jie Fang2Hui-Hui Fu3Li-Feng Wei4Yin-Yun Miao5Xin-Xin Guo6Xiao-Ling Weng7Department of Pediatrics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital, Yuyao Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo, ChinaDepartment of Ultrasound, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital, Yuyao Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo, ChinaDepartment of Medical Imaging, Ditang Central Health Center, Yuyao People’s Hospital Medical Community, Ningbo, ChinaDepartment of Pediatrics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital, Yuyao Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo, ChinaDepartment of Pediatrics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital, Yuyao Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo, ChinaDepartment of Pediatrics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital, Yuyao Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo, ChinaDepartment of Pediatrics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital, Yuyao Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo, ChinaDepartment of Pediatrics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital, Yuyao Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo, ChinaIntroductionIncreased intracranial pressure (ICP) is common with viral encephalitis in children which is associated with complications and prognosis. The optic nerve sheath diameter (ONSD) is a new indicator for the assessment of intracranial pressure using ultrasound, CT scan and MRI imaging. Given the influence of physical development on ONSD size in children, we expect more accurate assessment of intracranial pressure with ONSD/ETD (eyeball transverse diameter) ratio by ultrasound. The aim of the study is to determine the performance of the ONSD/ETD ratio measurement to predict ICP occurring in children with viral encephalitis and evaluate the therapeutic effect.MethodsChildren with viral encephalitis from May 2022 to June 2024 were recruited in this study. The initial ONSD/ETD ratio measurement by ultrasound were completed before lumbar puncture. Children were divided into the increased ICP group and the normal ICP group based on whether the ICP was over 200 mmH2O measured by lumbar puncture. The ultrasound was repeated on the 3rd and 7th day of treatment.ResultsThe ONSD/ETD ratios measured in the two groups before treatment were 0.231 ± 0.019 and 0.182 ± 0.012, respectively (p < 0.01). The ONSD/ETD ratio on the 3rd day of treatment in the increased ICP group was significantly lower than the data before treatment (p < 0.01). The data on the 7th day of treatment in increased ICP group was significantly lower than the data before treatment (p < 0.01), but not statistically significant compared to the data on the 3rd day of treatment (p = 0.650). The ROC curve demonstrated an AUC for ONSD/ETD ratio in predicting the occurrence of increased ICP in children with viral encephalitis was 0.974 [95% confidence interval (CI): 0.939–1.000, p < 0.01], with a sensitivity of 95.1% and specificity of 93.3% at a cut-off value of 0.198.ConclusionOur study shows that ONSD/ETD can be used as an easy reference tool for evaluating ICP in children with viral encephalitis which can reflect the therapeutic effect.https://www.frontiersin.org/articles/10.3389/fped.2024.1485107/fullpediatricsoptic nerve sheath diameterONSD/ETDincreased intracranial pressureviral encephalitisultrasound
spellingShingle Chun Zhao
Peng-Cheng Sun
Ke-Jie Fang
Hui-Hui Fu
Li-Feng Wei
Yin-Yun Miao
Xin-Xin Guo
Xiao-Ling Weng
Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis
Frontiers in Pediatrics
pediatrics
optic nerve sheath diameter
ONSD/ETD
increased intracranial pressure
viral encephalitis
ultrasound
title Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis
title_full Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis
title_fullStr Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis
title_full_unstemmed Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis
title_short Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis
title_sort optic nerve sheath diameter eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis
topic pediatrics
optic nerve sheath diameter
ONSD/ETD
increased intracranial pressure
viral encephalitis
ultrasound
url https://www.frontiersin.org/articles/10.3389/fped.2024.1485107/full
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