Accepted for/Published in: JMIR Perioperative Medicine
Date Submitted: Nov 17, 2024
Date Accepted: Jan 19, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
COMPARISON BETWEEN ULTRASOUND AND MRI MEASUREMENTS OF THE OPTIC NERVE SHEATH DIAMETER IN PATIENTS UNDERGOING INTRACRANIAL SURGERY: A prospective observational single-center study.
ABSTRACT
Background:
The cystic nature and easy accessibility of the eye make ocular ultrasound a valuable tool for thorough assessment. High-frequency ultrasound transducers allow for clear visualizing of normal eye anatomy and detecting various intraocular issues such as tumours, retinal detachment, vitreous hemorrhage, foreign bodies, and vascular malformations.
Objective:
We are investigating and analyzing the relationship and potential bias between ultrasound—and MRI-based measurements of the ONSD. Our main objective is to determine how both techniques can be used together to assess the ONSD and ICP during the perioperative period. We also aim to establish how different these measurements could be from the MRI gold standard when performed by a well-trained anesthesiologist using ultrasound.
Methods:
We conducted a prospective observational study of 50 adult patients scheduled for intracranial surgery at LHSC (University Hospital) between July 2021 and May 2023. The study focused on patients undergoing supratentorial brain tumour resections.
Results:
The optic nerve sheath diameter measurements obtained through the ultrasound were positively correlated with those measured by magnetic resonance. The average optic nerve sheath diameter in the right eye measured 5.940 mm (±0.986) using ultrasound and 6.284 mm (±0.939) with radiological assessment, with differences ranging from -1 mm to 1.8 mm. In the left eye, the average optic nerve sheath diameter was higher, recorded at 6.146 mm (±0.935) with ultrasound and 6.298 mm (±0.860) with radiological assessment, and the differences ranged from -1 mm to 1.7 mm.
Conclusions:
The ONSD measurement is a valuable, easy-to-learn, non-invasive method that can be crucial in the acute management of patients with neurological conditions before surgery, and our research shows that ultrasound can provide a reliable means for continuous monitoring and prompt intervention, especially when intraoperative fluctuations in intracranial pressure are a significant concern. Clinical Trial: None
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