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Related Experiment Video

Updated: Jan 13, 2026

Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition
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Net optic nerve sheath diameter as a factor for predicting intracranial hypertension.

Chi Niu1, Yifan Wang1, Bin Xu1

  • 1Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Quantitative Imaging in Medicine and Surgery
|January 12, 2026
PubMed
Summary

The net optic nerve sheath diameter (nONSD) measured via MRI shows promise as a non-invasive method for detecting elevated intracranial pressure (ICP). This finding could aid in managing neurological emergencies.

Keywords:
Intracranial hypertension (ICP)emergency departmentoptic nerve sheath diameter (ONSD)

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Area of Science:

  • Neurology
  • Radiology
  • Ophthalmology

Background:

  • Intracranial pressure (ICP) assessment is vital for neurological emergencies.
  • Invasive ICP monitoring is controversial, necessitating alternative methods.
  • Cranial MRI offers a non-invasive approach to evaluate ICP-related parameters.

Purpose of the Study:

  • To assess correlations between optic nerve parameters from cranial MRI and ICP.
  • To evaluate the diagnostic value of these parameters in predicting intracranial hypertension.
  • To explore the potential of non-invasive MRI-based measurements for ICP assessment.

Main Methods:

  • Retrospective analysis of 112 patients with suspected intracranial infections.
  • Measurement of optic nerve diameter (OND), optic nerve sheath diameter (ONSD), and eyeball transverse diameter (EBTD) via cranial MRI.
  • Calculation of net optic nerve sheath diameter (nONSD) and ONSD:EBTD ratio; ICP measured via lumbar puncture.

Main Results:

  • Patients with intracranial hypertension showed significantly higher ONSD, nONSD, and ONSD/EBTD compared to those with normal ICP.
  • Significant linear correlations were observed between nONSD and ICP (r=0.61), ONSD and ICP (r=0.36), and ONSD/EBTD and ICP (r=0.36).
  • nONSD demonstrated promising predictive accuracy for elevated ICP, with 88.7% specificity and 80% positive predictive value at a threshold of 2.52 mm.

Conclusions:

  • Net optic nerve sheath diameter (nONSD) shows strong potential as a non-invasive predictor of elevated ICP.
  • Further prospective studies are required to validate nONSD's generalizability and clinical utility.
  • Cranial MRI-derived nONSD may offer a valuable tool in managing neurological emergencies related to ICP.