Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging

BMC Neurol. 2013 Dec 1;13:187. doi: 10.1186/1471-2377-13-187.


Background: Quantification of the optic nerve sheath diameter (ONSD) by transbulbar sonography is a promising non-invasive technique for the detection of altered intracranial pressure. In order to establish this method as follow-up tool in diseases with intracranial hyper- or hypotension scan-rescan reproducibility and accuracy need to be systematically investigated.

Methods: The right ONSD of 15 healthy volunteers (mean age 24.5 ± 0.8 years) were measured by both transbulbar sonography (9 - 3 MHz) and 3 Tesla MRI (half-Fourier acquisition single-shot turbo spin-echo sequences, HASTE) 3 and 5 mm behind papilla. All volunteers underwent repeated ultrasound and MRI examinations in order to assess scan-rescan reproducibility and accuracy. Moreover, inter- and intra-observer variabilities were calculated for both techniques.

Results: Scan-rescan reproducibility was robust for ONSD quantification by sonography and MRI at both depths (r > 0.75, p ≤ 0.001, mean differences < 2%). Comparing ultrasound- and MRI-derived ONSD values, we found acceptable agreement between both methods for measurements at a depth of 3 mm (r = 0.72, p = 0.002, mean difference < 5%). Further analyses revealed good inter- and intra-observer reliability for sonographic measurements 3 mm behind the papilla and for MRI at 3 and 5 mm (r > 0.82, p < 0.001, mean differences < 5%).

Conclusions: Sonographic ONSD quantification 3 mm behind the papilla can be performed with good reproducibility, measurement accuracy and observer agreement. Thus, our findings emphasize the feasibility of this technique as a non-invasive bedside tool for longitudinal ONSD measurements.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Healthy Volunteers
  • Humans
  • Magnetic Resonance Imaging*
  • Myelin Sheath / diagnostic imaging*
  • Observer Variation
  • Optic Nerve / anatomy & histology*
  • Optic Nerve / diagnostic imaging*
  • Reproducibility of Results
  • Retrospective Studies
  • Ultrasonography, Doppler, Transcranial*
  • Young Adult