机构：[1]Department of Neurology, The First Hospital of Jilin University, Changchun, China,[2]Department of Neurology, Changchun People’s Hospital, Changchun, China,[3]Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China医技科室血管超声科首都医科大学宣武医院
Background: The clinical presentation of cerebral venous sinus thrombosis (CVST) overlaps with that of idiopathic intracranial hypertension (IIH), but no screening tool exists. We investigated the role of eye-neck integrated ultrasound in the diagnosis and differentiation of IIH and CVST. Methods: Twenty IIH patients, 30 CVST patients, and 40 healthy controls were retrospectively analyzed. The ultrasonographic optic nerve sheath diameter (ONSD) and hemodynamic characteristics of the internal jugular veins (IJVs) were recorded. The cerebrospinal fluid opening pressure was measured after ultrasonic examination. Results: The ONSD was significantly larger in IIH patients than in controls (4.71 +/- 0.41 vs. 3.93 +/- 0.24mm, p < 0.001). The ONSD cut-off for IIH diagnosis was 4.25mm (AUC = 0.978; 95% CI: 0.95-1.0, p < 0.001, sensitivity: 90%, specificity: 93%). In the CVST group, 22 (73.3%) patients had elevated intracranial pressure (ICP); the mean ONSD was significantly higher in patients with increased ICP than in those without (4.43 +/- 0.33 vs. 3.95 +/- 0.17mm, p < 0.001). The mean blood flow volume (BFV) was significantly reduced in CVST patients (425.17 +/- 349.83 mL/min) compared to that in controls (680.37 +/- 233.03 mL/min, p < 0.001) and IIH patients (617.67 +/- 282.96 mL/min, p = 0.008). The optimal BFV cut-off for predicting CVST was 527.28 mL/min (AUC = 0.804, 95% CI: 0.68-0.93, p < 0.001, sensitivity: 80%, specificity: 78%). The velocity of the unilateral IJVs-J3 segment decreased or remained constant during deep inspiration (abnormal respiratory modulate blood flow test, ARMT) in 32.5% of controls, with no bilateral ARMT. The prevalence of bilateral ARMT was 25% in IIH patients (chi(2) = 12.9, p = 0.005) and 27% in CVST patients (chi(2) = 17.6, p = 0.001). Conclusion: Eye-neck integrated ultrasound is an easily available bedside technique to assess ICP and hemodynamic characteristics of IJVs. ONSD measurement can identify patients with increased ICP, and reduced IJV BFV may aid the differentiation of CVST and IIH.
基金：
This work was supported by the National Natural Science
Foundation of China (No. 81801707) and Special Project
for Medical and Sanitary Talent of Jilin Province (No.
JLSWSRCZX2020-037).
第一作者机构：[1]Department of Neurology, The First Hospital of Jilin University, Changchun, China,[2]Department of Neurology, Changchun People’s Hospital, Changchun, China,
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Li Liu,Yingqi Xing,Ying Chen,et al.Eye-Neck Integrated Ultrasound in Idiopathic Intracranial Hypertension and Cerebral Venous Sinus Thrombosis[J].FRONTIERS IN NEUROLOGY.2021,12:doi:10.3389/fneur.2021.696665.
APA：
Li Liu,Yingqi Xing,Ying Chen,Xiaorui Ji,Jiaojiao Ge&Lijuan Wang.(2021).Eye-Neck Integrated Ultrasound in Idiopathic Intracranial Hypertension and Cerebral Venous Sinus Thrombosis.FRONTIERS IN NEUROLOGY,12,
MLA：
Li Liu,et al."Eye-Neck Integrated Ultrasound in Idiopathic Intracranial Hypertension and Cerebral Venous Sinus Thrombosis".FRONTIERS IN NEUROLOGY 12.(2021)
