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. 2022 Apr 1:87:e202-e206.
doi: 10.5114/pjr.2022.115706. eCollection 2022.

Optic nerve sheath diameter and its implications in the evaluation of cerebral venous sinus thrombosis

Sudha Kiran Das  1 , Saurabh Jindal  1 , Vikram Patil  1 , T Sachin  1
Affiliations

Optic nerve sheath diameter and its implications in the evaluation of cerebral venous sinus thrombosis

Sudha Kiran Das et al. Pol J Radiol. .

Abstract

Purpose: To ascertain the role of optic nerve sheath diameter (ONSD) in the evaluation of cerebral venous sinus thrombosis (CVST).

Material and methods: A retrospective study with convenient sampling was done during the period November 2018 to January 2020. Forty-one patients across all age groups with magnetic resonance venography (MRV) diagnosis of CVST and 82 gender-matched controls were included in the study. ONSD was measured on axial T2-weighted magnetic resonance images. CVST was identified on axial TOF-MRV including the stage, degree, and location. Intraparenchymal infarction and haemorrhage were also noted with their stage and size. The distribution of values for ONSD was tested for equality of variances using independent samples t-test. A cut-off value for ONSD was derived using ROC analysis.

Results: The mean difference between ONSD of cases and controls was 0.84 mm (95% CI: 0.61-1.06) and was statistically significant at p < 0.001. Mean ONSD in cases was 5.33 ± 0.66, and in the control group it was 4.49 ± 0.31. The cut-off value for ONSD was taken as 4.57 mm, derived using the ROC analysis (AUC was 0.876 suggesting good diagnostic accuracy). ONSD showed a sensitivity of 87% and a negative predictive value of 89% in predicting CVST. However, we found no statistical significance between ONSD in patients with acute or chronic thrombosis or in those with neuroparenchymal complications.

Conclusions: ONSD is a valid triage tool with high sensitivity and negative predictive value, and it can be used in the evaluation of CVST.

Keywords: MRI; cerebral venous sinus thrombosis; optic nerve sheath diameter.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
ROC curve. Test result variable: averaged optic nerve sheath diameter (mm). AUC – 0.876
Figure 2
Figure 2
A patient with acute cerebral venous sinus thrombosis. A) Axial T2WI showing bilateral increased optic nerve sheath diameter. B) Coronal TOF-MRV image showing complete absence of flow related signal in superior sagittal sinus, bilateral transverse sinuses, and left sigmoid sinus, suggestive of acute thrombosis. C) Axial T1WI showing hyperintense signal in the region of superior sagittal sinus consistent with thrombosis
Figure 3
Figure 3
A patient with chronic cerebral venous sinus thrombosis. A) Axial T2WI showing bilateral increased optic nerve sheath diameter. B) Sagittal TOF-MRV image showing multiple tortuous collaterals and venous channels, consistent with chronic thrombosis
See this image and copyright information in PMC

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