Application Of Conventional Ultrasound And Shear Wave Elastography In Patients With Increased Intracranial Pressure

ObjectTo explore the application value of transorbital grayscale ultrasound,doppler ultrasound and shear wave elastography in evaluation of increased intracranial pressure and in analysis of hemodynamics of the eye and in detection of retrobulbar soft tissue biomechanical properties in patients with increased intracranial pressure.MethodsConventional grayscale ultrasound,doppler ultrasound and shear wave elastography were applied to 54 healthy subjects and 54 patients diagnosed with increased intracranial pressure,29 patients with brain tumors,25 patients with intracranial hemorrhage.Analyze the intracranial pressure and optic nerve sheath diameter(ONSD)in patients with increased intracranial pressure,and compared ONSD,doppler ultrasound measurements including peak systolic velocity(PSV)、 end diastolic velocity(EDV)and resistance index(RI)of central retina artery(CRA)and maximal velocity(Vmax)of central retina vein(CRV)and shear wave elastography measurements including mean Young’s modulus(Emean)of optic nerve head(ONH),peripapillary sclera(PPsc)and optic nerve(ON)among groups.ResultsThere were no significant differences among the three groups in terms of age or gender(p>0.05 for both).The mean intracranial pressure values between the tumor group and hemorrhage group were similar(p>0.05).The CRA-PSV,CRA-EDV and CRV-Vmax were significantly lower in tumor group and hemorrhage group than control group(p<0.05 for all).The ONSD,CRA-RI,Emean of ONH and Emean of PPsc were significantly greater in tumor group and hemorrhage group than control group(p<0.05 for all).There was significant positive correlation between intracranial pressure and ONSD in patients with increased intracranial pressure(r=0.749,p<0.01).There was a significant difference of the Emean of ON between tumor group and control group(p<0.05).However,there was no difference between the hemorrhage group and control group(p>0.05).The tumor group and hemorrhage group had a similar ONSD,blood flow parameters and elastic parameters(p>0.05 for all).ConclusionMeasurement of ONSD by grayscale ultrasound can evaluate intracranial pressure in a non-invasive way,transorbital doppler ultrasound and shear wave elastography could quantitative analyze hemodynamics of the eye and biomechanical properties information of the retrobulbar tissue,providing evidence for early diagnosis of visual impairments and guiding the clinical treatment.