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Indian J Crit Care Med. 2015 Aug;19(8):466-70. doi: 10.4103/0972-5229.162465.

Correlation of measurement of optic nerve sheath diameter using ultrasound with magnetic resonance imaging.

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Department of Critical Care Medicine, Yashoda Super Speciality Hospital, Hyderabad, Telangana, India.
Department of Radiology, Yashoda Super Speciality Hospital, Hyderabad, Telangana, India.



Analysis to correlate the measurements of optic nerve sheath diameter (ONSD) obtained by using ultrasound to magnetic resonance imaging (MRI) techniques in order to establish the accuracy of ocular sonography as a noninvasive modality for detecting raised intracranial pressure (ICP).


A prospective, observational study was performed in 100 cases of adult meningoencephalitis patients admitted to Intensive Care Unit in whom MRI was performed for neurodiagnosis. ONSD was measured in such patients, 3 mm behind the globe in each eye. A mean binocular ONSD >4.6 mm in female and 4.8 mm in male was taken as cut-off values for diagnosing raised ICP. This was compared with ONSD measured on T2-weighted MRI image measured 3 mm behind the globe. The reading obtained from both the methods were compared with Bland-Altman analysis for correlation and the findings were tabulated.


The mean ONSD values measured with ultrasonography (USG) and MRI for female were 5.48 ± 0.43 mm and 5.68 ± 0.44 mm and for male were 5.40 ± 0.37 mm and 5.56 ± 0.38 mm, respectively. The mean age of the female and male was 53.90 ± 17.84 and 56.06 ± 15.67 years, respectively. On comparing ultrasound with MRI-derived ONSD values, we found acceptable agreement between both methods for measurements at a depth of 3 mm (r = 0.02, P < 0.001).


In our study, we have found a good correlation between ocular USG and MRI of ONSD. The study has shown agreement with the fact that ocular sonography can be used as a noninvasive tool for detecting raised ICP with accuracy.


Intensive Care Unit; magnetic resonance imaging; ocular sonography; optic nerve sheath diameter; raised intracranial pressure

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