超声测量成人视神经鞘直径诊断颅内高压症:Meta分析  

Ultrasonic measurement of adult optic nerve sheath diameter for diagnosis of intracranial hypertension:Meta-analysis

作　　者：王旭 杨丽娟 刘晓宇 姚娜 戴云跃 鲁睿文 WANG Xu;YANG Lijuan;LIU Xiaoyu;YAO Na;DAI Yunyue;LU Ruiwen(Baotou Clinical Medical College,Inner Mongolia Medical University,Baotou 014040,China;Baotou Medical College,Inner Mongolia University of Science Technology,Baotou 014040,China)

机构地区：[1]内蒙古医科大学包头临床医学院,内蒙古包头014040 [2]内蒙古科技大学包头医学院,内蒙古包头014040

出　　处：《中国医学影像技术》2022年第10期1464-1469,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用Meta分析方法评估超声测量视神经鞘直径(ONSD)诊断颅内高压症(ICH)的准确性及其诊断阈值。方法检索万方医学网、维普数据库、中国知网、PubMed、Web of Science、Medline及SinoMed数据库自建库至2021年12月31日收录的关于超声测量ONSD评估ICH的文献并进行筛选,提取相关数据。采用Stata 15.1、Meta Disc 1.4等软件对数据进行分析,评估ONSD诊断ICH的准确性;绘制受试工作者特征曲线,获取其诊断阈值。结果最终纳入12篇文献,包括568例ICH及816例颅内压正常患者。超声测量ONSD评价ICH的合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比及综合受试者特征曲线下面积分别为0.89[95%CI(0.87,0.92)]、0.88[95%CI(0.86,0.90)]、7.38[95%CI(4.71,11.56)]、0.13[95%CI(0.11,0.17)]、66.40[95%CI(36.35,121.30)]及0.92[95%CI(0.89,0.94)]。超声测量ONSD诊断ICH验前概率20.00%,验后概率升至69.00%。以ONSD≥5.01 mm为最佳阈值诊断ICH的敏感度和特异度均为83.30%。结论超声测量ONSD诊断ICH准确性较高;其最佳阈值为5.01 mm。Objective To observe the accuracy and cut-off value of ultrasound measurement of optic nerve sheath diameter(ONSD)for diagnosing intracranial hypertension(ICH)with meta-analysis.Methods Literature about ultrasonic measurement of ONSD for diagnosing ICH were searched in Wanfang Med Online,VIP databases,CNKI,PubMed,Web of Science,Medline,SinoMed platforms from the establishment of database to December 31,2021.The articles were then screened,and the relevant data were extracted.Stata 15.1,Meta Disc 1.4 and other software were used to analyze and evaluate the accuracy of ONSD for diagnosing ICH,and the characteristic curves of subjects were drawn to obtain the cut-off value.Results A total of 12 articles were enrolled,including 568 patients with ICH and 816 patients with normal intracranial pressure.The combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and the area under the summary characteristic curve of ultrasound measurement of ONSD for diagnosing ICH was 0.89(95%CI[0.87,0.92]),0.88(95%CI[0.86,0.90]),7.38(95%CI[4.71,11.56]),0.13(95%CI[0.11,0.17]),66.40(95%CI[36.35,121.30])and 0.92(95%CI[0.89,0.94]),respectively.The priori probability of ultrasonic measurement ONSD for diagnosing ICH was 20.00%,and the posteriori probability was up to 69.00%.Taken≥5.01 mm as the cut-off value of ONSD,the sensitivity and specificity of diagnosis of ICH was both 83.30%.Conclusion Ultrasonic measurement of ONSD had relatively high accuracy for diagnosing ICH,and the optimal cut-off value of ONSD was 5.01 mm.

关 键 词：视神经 颅内高压症 超声检查 荟萃分析 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]