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Intra- and interobserver reliability of transorbital sonographic assessment of the optic nerve sheath diameter and optic nerve diameter in healthy adults

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Abstract

Purpose

Transorbital optic nerve sonography (TOS) can measure the optic nerve inclusive the sheath diameter (ONSD) and the optic nerve diameter (OND), which are useful parameters in the diagnosis of several neurological disorders. Data on the reproducibility of TOS are, however, required to use B-mode sonography for clinical purposes. The aim of this study was to assess intra- and interobserver reliability of ultrasound-based evaluations of both OND and ONSD in healthy subjects.

Methods

Using a 4-11-MHz linear array transducer, the OND and ONSD of 20 healthy subjects were independently measured by two expert investigators.

Results

Depicting the optic nerve and its sheath was possible in all subjects. The intra- and interobserver reliability was high for both ONSD and OND measurements. Intraobserver agreement, analyzed with Cronbach´s Alpha, was higher for ONSD (range: 0.69–0.72) than for OND measurements (range: 0.55–0.65). No differences in interobserver reliability between ONSD and OND measurements were found (p = 0.83 for right and 0.47 for left eye).

Conclusions

Transorbital B-mode sonography is a feasible method to assess both ONSD and OND with a high intra- and interobserver reliability. Technical difficulties in differentiating the optic nerve from its sheaths may explain the lower intraobserver agreement for OND than that for ONSD measurements.

Sommario

Obiettivo La sonografia del nervo ottico per via transcranica (TOS) è in grado di misurare il diametro del nervo ottico inclusi i suoi rivestimenti (ONSD) o il diametro del solo nervo ottico (OND), parametri utili nella diagnostica di molte patologie neurologiche. È necessario tuttavia disporre di dati sulla riproducibilità di tale metodica, ottenuta in sonografia B-mode, per poterla applicare clinicamente. Obiettivo di questo studio è stato quello di determinare il grado di riproducibilità intra- e inter-osservatore nella determinazione di questi due parametri in soggetti sani.

Metodi

Due esaminatori hanno determinato in maniera indipendente valori di ONSD ed OND in 20 soggetti sani utilizzando una sonda ecografica a 4–11 MHz.

Risultati

In tutti i soggetti è stato possibile visualizzare il nervo ottico e i suoi rivestimenti. Sono stati ottenuti elevati valori di riproducibilità intra- e inter-osservatore nella determinazione dell'ONSD e dell'OND. La riproducibilità intra-osservatore, analizzata con il metodo del Cronbach´s Alpha, era maggiore per l'ONSD (range: 0.69–0.72) che per l'OND (range 0.55–0.65). Non sono state riscontrate differenze nella riproducibilità inter-osservatore tra ONSD ed OND (p = 0.83 per l'occhio destro e 0.47 per quello sinistro).

Conclusioni

La TOS è un metodo in grado di ottenere i valori di ONSD ed OND con elevato grado di riproducibilità intra- ed inter-osservatore. Difficoltà tecniche nel distinguere il nervo ottico dai suoi rivestimenti possono spiegare il minor grado di riproducibilità intra-osservatore per l'OND rispetto all'ONSD.

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Conflict of interest

Piergiorgio Lochner, Lorenzo Coppo, Roberto Cantello, Raffaele Nardone, Andrea Naldi, Maurizio A. Leone, Francesco Brigo declare that they have no conflict of interest.

Human and animal studies

The study described in this article does not contain studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Neurology, General Hospital, Merano, Italy

    Piergiorgio Lochner & Raffaele Nardone

  2. Section of Neurology, Department of Translational Medicine, University of Piedmont East ‘‘A. Avogadro’’, Novara, Italy

    Piergiorgio Lochner, Lorenzo Coppo, Roberto Cantello & Andrea Naldi

  3. Neurology Unit, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy

    Maurizio A. Leone

  4. Section of Clinical Neurology, Department of Neurological and Movement Sciences, University of Verona, Piazzale L.A. Scuro, 10-37134, Verona, Italy

    Francesco Brigo

Authors
  1. Piergiorgio Lochner
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  2. Lorenzo Coppo
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  3. Roberto Cantello
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  4. Raffaele Nardone
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  5. Andrea Naldi
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  6. Maurizio A. Leone
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  7. Francesco Brigo
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Corresponding author

Correspondence to Francesco Brigo.

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Lochner, P., Coppo, L., Cantello, R. et al. Intra- and interobserver reliability of transorbital sonographic assessment of the optic nerve sheath diameter and optic nerve diameter in healthy adults. J Ultrasound 19, 41–45 (2016). https://doi.org/10.1007/s40477-014-0144-z

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  • DOI: https://doi.org/10.1007/s40477-014-0144-z

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