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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Neurology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1485107

Optic nerve sheath diameter/eyeball transverse diameter ratio by ultrasound in prediction of increased intracranial pressure in children with viral encephalitis

Provisionally accepted
Chun Zhao Chun Zhao 1*Cheng Peng Sun Cheng Peng Sun 2Jie Ke Fang Jie Ke Fang 3Hui Hui Fu Hui Hui Fu 1Feng Li Wei Feng Li Wei 1Yun Yin Miao Yun Yin Miao 1Xin Xin Guo Xin Xin Guo 1Ling Xiao Weng Ling Xiao Weng 1
  • 1 Department of Pediatrics, Yuyao People's Hospital, Yuyao, China
  • 2 Department of Ultrasound, Yuyao People's Hospital, Yuyao, China
  • 3 Department of Medical Imaging, Ditang Central Health Center, Yuyao People's Hospital medical community, Ningbo, China

The final, formatted version of the article will be published soon.

    Introduction: Increased intracranial pressure (ICP) is common with viral encephalitis in children which is associated with complications and prognosis. The optic nerve sheath diameter (ONSD) is a new indicator for the assessment of intracranial pressure using ultrasound, CT scan and MRI imaging. Given the influence of physical development on ONSD size in children, we expect more accurate assessment of intracranial pressure with ONSD/ETD (eyeball transverse diameter) ratio by ultrasound. The aim of the study is to determine the performance of the ONSD/ETD ratio measurement to predict ICP occurring in children with viral encephalitis and evaluate the therapeutic effect. Methods: Children with viral encephalitis from May 2022 to June 2024 were recruited in this study. The initial ONSD/ETD ratio measurement by ultrasound were completed before lumbar puncture. Children were divided into the increased ICP group and the normal ICP group based on whether the ICP was over 200mmH2O measured by lumbar puncture. The ultrasound was repeated on the 3 rd and 7 th day of treatment. Results: The ONSD/ETD ratios measured in the two groups before treatment were 0.2310.019 and 0.1820.012， respectively(p<0.01). The ONSD/ETD ratio on the 3 rd day of treatment in the increased ICP group was significantly lower than the data before treatment (p<0.01). The data on the 7 th day of treatment in increased ICP group was significantly lower than the data before treatment (p<0.01), but not statistically significant compared to the data on the 3 rd day of treatment (p=0.650). The ROC curve demonstrated an AUC for ONSD/ETD ratio in predicting the occurrence of increased ICP in children with viral encephalitis was 0.974 [95% confidence interval (CI): 0.939-1.000, p<0.01], with a sensitivity of 95.1% and specificity of 93.3% at a cut-off value of 0.198.Our study shows that ONSD/ETD can be used as an easy reference tool for evaluating ICP in children with viral encephalitis which can reflect the therapeutic effect.

    Keywords: Pediatrics, optic nerve sheath diameter, ONSD/ETD, Increased intracranial pressure, Viral Encephalitis, ultrasound

    Received: 23 Aug 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Zhao, Sun, Fang, Fu, Wei, Miao, Guo and Weng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chun Zhao, Department of Pediatrics, Yuyao People's Hospital, Yuyao, China

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