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Diffusion tensor imaging of the optic disc in idiopathic intracranial hypertension

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 28 November 2018

Abstract

Purpose

To study optic disc in idiopathic intracranial hypertension (IIH) with diffusion tensor imaging.

Methods

Prospective study was carried out on 31 consecutive patients with IIH and 17 age and sex-matched controls that underwent diffusion tensor imaging of optic nerve. Fractional anisotropy (FA) and mean diffusivity (MD) of optic disc were measured by two readers. Grades of papilledema and visual field defects were evaluated by ophthalmologist.

Results

FA of optic disc was significantly lower in IIH than controls (p = 0.001) with excellent inter-observer agreement (K = 0.93) of both readers. The cutoff FA used to differentiating IIH from controls were 0.28 and 0.29 with area under curve (AUC) of 0.921 and 0.914, accuracy 92% and 91%, and sensitivity 97% and 96%. MD of optic disc were significantly higher in IIH than in controls (p = 0.001) with excellent inter-observer agreement (K = 0.91) of both readers. The cutoff MD used to differentiating IIH from controls was 1.51 and 1.22 × 10−3 mm2/s with AUC 0.943 and 0.922, and accuracy 94% and 92% respectively. FA of optic disc was significantly lower in early than advanced papilledema and visual field defects (p = 0.001, 0.001) respectively. The MD of optic disc was significantly higher in early than advanced papilledema and visual field defects (p = 0.001, 0.001) respectively.

Conclusion

Diffusion tensor imaging parameters of optic disc are non-invasive reliable imaging parameters that can be used for diagnosis of IIH and well correlated with papilledema and visual field defects.

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Abbreviations

AUC:

Area under the curve

FA:

Fractional anisotropy

IIH:

Idiopathic intracranial hypertension

MD:

Mean diffusivity

ROC:

Receiver operating characteristics

References

  1. Wall M (2017) Update on idiopathic intracranial hypertension. Neurol Clin 35:45–57

    Article  Google Scholar 

  2. Portelli M, Papageorgiou PN (2017) An update on idiopathic intracranial hypertension. Acta Neurochir 159:491–499

    Article  Google Scholar 

  3. Chan JW (2017) Current concepts and strategies in the diagnosis and management of idiopathic intracranial hypertension in adults. J Neurol 264:1622–1633

    Article  CAS  Google Scholar 

  4. Mollan SP, Ali F, Hassan-Smith G, Botfield H, Friedman DI, Sinclair AJ (2016) Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management. J Neurol Neurosurg Psychiatry 87:982–992

    Article  Google Scholar 

  5. Markey KA, Mollan SP, Jensen RH, Sinclair AJ (2016) Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol 15:78–91

    Article  Google Scholar 

  6. Willenborg KD, Nacimiento W (2015) Characteristic neurological features, differential diagnostic criteria and medicinal treatment of idiopathic intracranial hypertension. Ophthalmologe 112:814–820

    Article  CAS  Google Scholar 

  7. Spitze A, Malik A, Lee AG (2014) Surgical and endovascular interventions in idiopathic intracranial hypertension. Curr Opin Neurol 27:69–74

    Article  Google Scholar 

  8. Aguilar-Pérez M, Martinez-Moreno R, Kurre W, Wendl C, Bäzner H, Ganslandt O, Unsöld R, Henkes H (2017) Endovascular treatment of idiopathic intracranial hypertension: retrospective analysis of immediate and long-term results in 51 patients. Neuroradiology 59:277–287

    Article  Google Scholar 

  9. Dinkin MJ, Patsalides A (2017) Venous sinus stenting for idiopathic intracranial hypertension: where are we now? Neurol Clin 35:59–81

    Article  Google Scholar 

  10. Bidot S, Saindane AM, Peragallo JH, Bruce BB, Newman NJ, Biousse V (2015) Brain imaging in idiopathic intracranial hypertension. J Neuroophthalmol 35:400–411

    Article  Google Scholar 

  11. Rajasekhar A, Veedu PT (2016) When to image in idiopathic intracranial hypertension. Indian J Radiol Imaging 26:528–529

    PubMed  PubMed Central  Google Scholar 

  12. Degnan AJ, Levy LM (2011) Pseudotumor cerebri: brief review of clinical syndrome and imaging findings. AJNR Am J Neuroradiol 32:1986–1993

    Article  CAS  Google Scholar 

  13. Bekerman I, Sigal T, Kimiagar I, Almer ZE, Vaiman M (2016) Diagnostic value of the optic nerve sheath diameter in pseudotumor cerebri. J Clin Neurosci 30:106–109

    Article  Google Scholar 

  14. Zur D, Anconina R, Kesler A, Lublinsky S, Toledano R, Shelef I (2017) Quantitative imaging biomarkers for dural sinus patterns in idiopathic intracranial hypertension. Brain Behav 7:e00613

    Article  Google Scholar 

  15. Dong C, Zheng YM, Li XL, Wang HX, Hao DP, Nie P, Pang J, Xu WJ (2016) Morphometric MRI changes in intracranial hypertension due to cerebral venous thrombosis: a retrospective imaging study. Clin Radiol 71:691–697

    Article  Google Scholar 

  16. Abdel Razek A, El-Serougy L, Abdelsalam M et al (2018) Differentiation of residual/recurrent gliomas from post-radiation changes with arterial spin labeling and diffusion tensor magnetic resonance imaging derived metrics. Neuroradiology 60:169–177

    Article  Google Scholar 

  17. El-Serougy L, Abdel Razek AA, Ezzat A et al (2016) Assessment of diffusion tensor imaging metrics in differentiating low-grade from high-grade gliomas. Neuroradiol J 29:400–407

    Article  Google Scholar 

  18. Razek AA, Shabana AA, El Saied TO et al (2017) Diffusion tensor imaging of mild-moderate carpal tunnel syndrome: correlation with nerve conduction study and clinical tests. Clin Rheumatol 36:2319–2324

    Article  Google Scholar 

  19. Razek AAKA, Al-Adlany MAAA, Alhadidy AM et al (2017) Diffusion tensor imaging of the renal cortex in diabetic patients: correlation with urinary and serum biomarkers. Abdom Radiol 42:1493–1500

    Article  Google Scholar 

  20. Wang L, Fan K, Zhang Y, Chen Y, Tian Q, Shi D (2017) Quantitative assessment of optic nerve in patients with Leber’s hereditary optic neuropathy using reduced field-of-view diffusion tensor imaging. Eur J Radiol 93:24–29

    Article  Google Scholar 

  21. Lee H, Lee YH, Suh SI, Jeong EK, Baek S, Seo HS (2018) Characterizing intraorbital optic nerve changes on diffusion tensor imaging in thyroid eye disease before dysthyroid optic neuropathy. J Comput Assist Tomogr 42:293–298

    Article  Google Scholar 

  22. Chen J, Zhu L, Li H, Lu Z, Chen X, Fang S (2016) Diffusion tensor imaging of occult injury of optic radiation following optic neuritis in multiple sclerosis. Exp Ther Med 12:2505–2510

    Article  CAS  Google Scholar 

  23. Sidek S, Ramli N, Rahmat K, Ramli NM, Abdulrahman F, Tan LK (2014) Glaucoma severity affects diffusion tensor imaging (DTI) parameters of the optic nerve and optic radiation. Eur J Radiol 83:1437–1441

    Article  CAS  Google Scholar 

  24. Gerlach DA, Marshall-Goebel K, Hasan KM, Kramer LA, Alperin N, Rittweger J (2017) MRI-derived diffusion parameters in the human optic nerve and its surrounding sheath during head-down tilt. NPJ Microgravity 3:18

    Article  Google Scholar 

  25. Yılmaz S, Yumusak E, Burulday V (2017) Changes of normal appearing optic nerve head on diffusion-weighted imaging in patients with diabetic retinopathy. Clin Imag 42:60–63

    Article  Google Scholar 

  26. Schmidt C, Wiener E, Lüdemann L, Kunte H, Kreutz KM, Becker N, Harms L, Klingebiel R, Hoffmann J (2017) Does IIH alter brain microstructures? - a DTI-based approach. Headache 57:746–755

    Article  Google Scholar 

  27. Friedman DI, Liu GT, Digre KB (2013) Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 81:1159–1165

    Article  Google Scholar 

  28. Frisen L (1982) Swelling of the optic nerve head: a staging scheme. J Neurol Neurosurg Psychiatry 45:13–18

    Article  CAS  Google Scholar 

  29. Shah VA, Kardon RH, Lee AG, Corbett JJ, Wall M (2008) Long-term follow-up of idiopathic intracranial hypertension: the Iowa experience. Neurology 70:634–640

    Article  CAS  Google Scholar 

  30. Passi N, Degnan AJ, Levy LM (2013) MR imaging of papilledema and visual pathways: effects of increased intracranial pressure and pathophysiologic mechanisms. AJNR Am J Neuroradiol 34:919–924

    Article  CAS  Google Scholar 

  31. Fleischman D, Perry JT, Rand Allingham R, Stinnett SS, Fleischman GM, Givre SJ, Chesnutt DA (2017) Retrospective analysis of translaminar, demographic, and physiologic parameters in relation to papilledema severity. Can J Ophthalmol 52:26–29

    Article  Google Scholar 

  32. Wall M, Johnson CA, Cello KE, Zamba KD, McDermott MP, Keltner JL, for the NORDIC Idiopathic Intracranial Hypertension Study Group (2016) Visual field outcomes for the idiopathic intracranial hypertension treatment trial (IIHTT). Invest Ophthalmol Vis Sci 57:805–812

    Article  CAS  Google Scholar 

  33. Hatem CF, Yri HM, Sørensen AL, Wegener M, Jensen RH, Hamann S (2018) Long-term visual outcome in a Danish population of patients with idiopathic intracranial hypertension. Acta Ophthalmol. https://doi.org/10.1111/aos.13664

    Article  Google Scholar 

  34. Abdel Razek AAK, Mukherji SK (2018) Imaging of posttreatment salivary gland tumors. Neuroimaging Clin N Am 28:199–208

    Article  Google Scholar 

  35. Abdel Razek AAK, Nada N (2018) Arterial spin labeling perfusion-weighted MR imaging: correlation of tumor blood flow with pathological degree of tumor differentiation, clinical stage and nodal metastasis of head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 275:1301–1307

    Article  Google Scholar 

  36. Razek AA, Abdalla A, Ezzat A et al (2014) Minimal hepatic encephalopathy in children with liver cirrhosis: diffusion-weighted MR imaging and proton MR spectroscopy of the brain. Neuroradiology 56:885–891

    Article  Google Scholar 

  37. Khalek Abdel Razek AA (2018) Characterization of salivary gland tumours with diffusion tensor imaging. Dentomaxillofac Radiol:20170343. https://doi.org/10.1259/dmfr.20170343

  38. Abdel Razek AAK (2018) Routine and advanced diffusion imaging modules of the salivary glands. Neuroimaging Clin N Am 28:245–254

    Article  Google Scholar 

  39. Sepahdari AR, Politi LS, Aakalu VK, Kim HJ, Razek AAKA (2014) Diffusion-weighted imaging of orbital masses: multi-institutional data support a 2-ADC threshold model to categorize lesions as benign, malignant, or indeterminate. AJNR Am J Neuroradiol 35:170–175

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt

    Ahmed Abdel Khalek Abdel Razek & Nihal Batouty

  2. Department of Neurology, Mansoura Faculty of Medicine, Mansoura, Egypt

    Wesam Fathy

  3. Department of Ophthalmology, Mansoura Faculty of Medicine, Mansoura, Egypt

    Rania Bassiouny

Authors
  1. Ahmed Abdel Khalek Abdel Razek
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  2. Nihal Batouty
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  3. Wesam Fathy
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  4. Rania Bassiouny
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Correspondence to Ahmed Abdel Khalek Abdel Razek.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Razek, A.A.K.A., Batouty, N., Fathy, W. et al. Diffusion tensor imaging of the optic disc in idiopathic intracranial hypertension. Neuroradiology 60, 1159–1166 (2018). https://doi.org/10.1007/s00234-018-2078-1

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  • DOI: https://doi.org/10.1007/s00234-018-2078-1

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