Effect of General Anesthesia on MR Optic Nerve Sheath Diameter in the Pediatric Population
Background Papilledema is thought to be the hallmark sign of increased intracranial pressure (ICP). Distension of the subarachnoid space within the optic nerve sheath is also commonly reported in MR studies as an indirect sign of increased ICP. Hypothesis General anesthesia and positive pressure ven...
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| Veröffentlicht in: | Journal of magnetic resonance imaging 2023-12, Vol.58 (6), p.1875-1881 |
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| description | Background
Papilledema is thought to be the hallmark sign of increased intracranial pressure (ICP). Distension of the subarachnoid space within the optic nerve sheath is also commonly reported in MR studies as an indirect sign of increased ICP.
Hypothesis
General anesthesia and positive pressure ventilation might result in changes in optic sheath diameter (OSD) observed on clinical brain MRI.
Study Type
Retrospective.
Population
One hundred forty‐five patients (154 MRI scans, 7.3 years ± 5.1); 97 studies in the anesthesia group (4.4 years ± 3.4) of which 22 had papilledema, and 57 in the non‐anesthesia group (12.3 years ± 3.2), of which 28 had papilledema.
Field Strength/Sequence
1.5T or 3.0T volumetric T2 images. T2 images were obtained from different vendors.
Assessment
OSD, optic nerve diameter (OND), and peri‐optic cerebrospinal fluid (CSF) were measured manually on T2‐weighted MR images for various population subgroups (with and without anesthesia; with or without papilledema). The correlation between these measurements and the clinical diagnosis of papilledema was evaluated via receiver operating characteristic (ROC) analysis.
Statistical Tests
Chi‐square test; Mann–Whitney Test; Spearman's test and ROCs; Interclass correlation coefficient, P = 0.05.
Results
General anesthesia resulted in significantly larger mean OSD in patients with or without papilledema (7.3 ± 1.0 mm vs. 6.1 ± 1.1 mm and 6.7 ± 1.0 mm vs. 5.4 ± 0.9 mm, respectively). In the non‐anesthesia group, the average OSD values (6.1 ± 1.1 mm) were significantly higher in papilledema patients compared to non‐papilledema patients (5.4 ± 0.9 mm), with larger peri‐optic CSF rim (1.6 ± 0.4 mm vs. 1.3 ± 0.3 mm). In the anesthesia group, OND was significantly larger in papilledema patients (3.4 ± 0.4 mm vs. 3.1 ± 0.5 mm), though the average peri‐optic CSF rim did not reach a significance in papilledema compared with non‐papilledema patients (2.0 ± 0.3 mm vs. 1.8 ± 0.4 mm, P = 0.06). In patients with general anesthesia, peri‐optic CSF rim had a limited correlation with increased ICP.
Data Conclusion
In the pediatric population, imaging findings of increased OSD on brain MRI might be related to general anesthesia rather than increased ICP. The interpretation of optic nerve sheath distention should be reported cautiously in conjunction with anesthesia status, especially in the pediatric population.
Evidence Level: 4
Technical Efficacy: 5 |
| doi_str_mv | 10.1002/jmri.28734 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2800627737</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2800627737</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3164-e0f5085e0a4fd45305480abbe53274c0b26a0c15124dc964680e02393b36b6193</originalsourceid><addsrcrecordid>eNp90ElLxDAYxvEgivvFDyABLyJU36xNjzLuuOFy8VLSzlsmQ5cxaRW_vRlHPXjwlBx-_Hl5CNlhcMgA-NG08e6Qm1TIJbLOFOcJV0Yvxz8okTAD6RrZCGEKAFkm1SpZEykobjisk5fTqsKyp11Fz7FFb2t63GLoJxicpV1Lbx7o3ax3Jb1F_4b0cYK2n9ATZxvs0VPX0mjpPY6d7X1k991sqG3vunaLrFS2Drj9_W6S57PTp9FFcn13fjk6vk5KwbRMECoFRiFYWY2lEqCkAVsUqARPZQkF1xZKphiX4zLTUhtA4CIThdCFZpnYJPuL7sx3r0O8PW9cKLGubYvdEHJuADRPU5FGuveHTrvBt_G6qIzOUgA5Dx4sVOm7EDxW-cy7xvqPnEE-XzyfL55_LR7x7ndyKBoc_9KfiSNgC_Duavz4J5Vf3TxcLqKfbVKIrQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2886970049</pqid></control><display><type>article</type><title>Effect of General Anesthesia on MR Optic Nerve Sheath Diameter in the Pediatric Population</title><source>Wiley Online Library All Journals</source><creator>Cohen, Israel ; Kraus, Matan ; Greenberg, Gahl ; Hoffmann, Chen ; Shrot, Shai</creator><creatorcontrib>Cohen, Israel ; Kraus, Matan ; Greenberg, Gahl ; Hoffmann, Chen ; Shrot, Shai</creatorcontrib><description>Background
Papilledema is thought to be the hallmark sign of increased intracranial pressure (ICP). Distension of the subarachnoid space within the optic nerve sheath is also commonly reported in MR studies as an indirect sign of increased ICP.
Hypothesis
General anesthesia and positive pressure ventilation might result in changes in optic sheath diameter (OSD) observed on clinical brain MRI.
Study Type
Retrospective.
Population
One hundred forty‐five patients (154 MRI scans, 7.3 years ± 5.1); 97 studies in the anesthesia group (4.4 years ± 3.4) of which 22 had papilledema, and 57 in the non‐anesthesia group (12.3 years ± 3.2), of which 28 had papilledema.
Field Strength/Sequence
1.5T or 3.0T volumetric T2 images. T2 images were obtained from different vendors.
Assessment
OSD, optic nerve diameter (OND), and peri‐optic cerebrospinal fluid (CSF) were measured manually on T2‐weighted MR images for various population subgroups (with and without anesthesia; with or without papilledema). The correlation between these measurements and the clinical diagnosis of papilledema was evaluated via receiver operating characteristic (ROC) analysis.
Statistical Tests
Chi‐square test; Mann–Whitney Test; Spearman's test and ROCs; Interclass correlation coefficient, P = 0.05.
Results
General anesthesia resulted in significantly larger mean OSD in patients with or without papilledema (7.3 ± 1.0 mm vs. 6.1 ± 1.1 mm and 6.7 ± 1.0 mm vs. 5.4 ± 0.9 mm, respectively). In the non‐anesthesia group, the average OSD values (6.1 ± 1.1 mm) were significantly higher in papilledema patients compared to non‐papilledema patients (5.4 ± 0.9 mm), with larger peri‐optic CSF rim (1.6 ± 0.4 mm vs. 1.3 ± 0.3 mm). In the anesthesia group, OND was significantly larger in papilledema patients (3.4 ± 0.4 mm vs. 3.1 ± 0.5 mm), though the average peri‐optic CSF rim did not reach a significance in papilledema compared with non‐papilledema patients (2.0 ± 0.3 mm vs. 1.8 ± 0.4 mm, P = 0.06). In patients with general anesthesia, peri‐optic CSF rim had a limited correlation with increased ICP.
Data Conclusion
In the pediatric population, imaging findings of increased OSD on brain MRI might be related to general anesthesia rather than increased ICP. The interpretation of optic nerve sheath distention should be reported cautiously in conjunction with anesthesia status, especially in the pediatric population.
Evidence Level: 4
Technical Efficacy: 5</description><identifier>ISSN: 1053-1807</identifier><identifier>EISSN: 1522-2586</identifier><identifier>DOI: 10.1002/jmri.28734</identifier><identifier>PMID: 37052820</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Anesthesia ; Brain ; Cerebrospinal fluid ; children ; Correlation coefficient ; Correlation coefficients ; Diameters ; Distension ; Field strength ; General anesthesia ; intracranial hypertension ; Intracranial pressure ; Magnetic resonance imaging ; Mechanical ventilation ; Medical imaging ; MRI ; Nerves ; Neuroimaging ; Optic nerve ; Patients ; Pediatrics ; Population studies ; pseudotumor cerebri ; sedation ; Sheaths ; Statistical analysis ; Statistical tests ; Subarachnoid space ; Subgroups ; Swelling</subject><ispartof>Journal of magnetic resonance imaging, 2023-12, Vol.58 (6), p.1875-1881</ispartof><rights>2024 The Author(s). Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.</rights><rights>2023 International Society for Magnetic Resonance in Medicine.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3164-e0f5085e0a4fd45305480abbe53274c0b26a0c15124dc964680e02393b36b6193</cites><orcidid>0000-0001-8954-3244</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmri.28734$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmri.28734$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37052820$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cohen, Israel</creatorcontrib><creatorcontrib>Kraus, Matan</creatorcontrib><creatorcontrib>Greenberg, Gahl</creatorcontrib><creatorcontrib>Hoffmann, Chen</creatorcontrib><creatorcontrib>Shrot, Shai</creatorcontrib><title>Effect of General Anesthesia on MR Optic Nerve Sheath Diameter in the Pediatric Population</title><title>Journal of magnetic resonance imaging</title><addtitle>J Magn Reson Imaging</addtitle><description>Background
Papilledema is thought to be the hallmark sign of increased intracranial pressure (ICP). Distension of the subarachnoid space within the optic nerve sheath is also commonly reported in MR studies as an indirect sign of increased ICP.
Hypothesis
General anesthesia and positive pressure ventilation might result in changes in optic sheath diameter (OSD) observed on clinical brain MRI.
Study Type
Retrospective.
Population
One hundred forty‐five patients (154 MRI scans, 7.3 years ± 5.1); 97 studies in the anesthesia group (4.4 years ± 3.4) of which 22 had papilledema, and 57 in the non‐anesthesia group (12.3 years ± 3.2), of which 28 had papilledema.
Field Strength/Sequence
1.5T or 3.0T volumetric T2 images. T2 images were obtained from different vendors.
Assessment
OSD, optic nerve diameter (OND), and peri‐optic cerebrospinal fluid (CSF) were measured manually on T2‐weighted MR images for various population subgroups (with and without anesthesia; with or without papilledema). The correlation between these measurements and the clinical diagnosis of papilledema was evaluated via receiver operating characteristic (ROC) analysis.
Statistical Tests
Chi‐square test; Mann–Whitney Test; Spearman's test and ROCs; Interclass correlation coefficient, P = 0.05.
Results
General anesthesia resulted in significantly larger mean OSD in patients with or without papilledema (7.3 ± 1.0 mm vs. 6.1 ± 1.1 mm and 6.7 ± 1.0 mm vs. 5.4 ± 0.9 mm, respectively). In the non‐anesthesia group, the average OSD values (6.1 ± 1.1 mm) were significantly higher in papilledema patients compared to non‐papilledema patients (5.4 ± 0.9 mm), with larger peri‐optic CSF rim (1.6 ± 0.4 mm vs. 1.3 ± 0.3 mm). In the anesthesia group, OND was significantly larger in papilledema patients (3.4 ± 0.4 mm vs. 3.1 ± 0.5 mm), though the average peri‐optic CSF rim did not reach a significance in papilledema compared with non‐papilledema patients (2.0 ± 0.3 mm vs. 1.8 ± 0.4 mm, P = 0.06). In patients with general anesthesia, peri‐optic CSF rim had a limited correlation with increased ICP.
Data Conclusion
In the pediatric population, imaging findings of increased OSD on brain MRI might be related to general anesthesia rather than increased ICP. The interpretation of optic nerve sheath distention should be reported cautiously in conjunction with anesthesia status, especially in the pediatric population.
Evidence Level: 4
Technical Efficacy: 5</description><subject>Anesthesia</subject><subject>Brain</subject><subject>Cerebrospinal fluid</subject><subject>children</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Diameters</subject><subject>Distension</subject><subject>Field strength</subject><subject>General anesthesia</subject><subject>intracranial hypertension</subject><subject>Intracranial pressure</subject><subject>Magnetic resonance imaging</subject><subject>Mechanical ventilation</subject><subject>Medical imaging</subject><subject>MRI</subject><subject>Nerves</subject><subject>Neuroimaging</subject><subject>Optic nerve</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Population studies</subject><subject>pseudotumor cerebri</subject><subject>sedation</subject><subject>Sheaths</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><subject>Subarachnoid space</subject><subject>Subgroups</subject><subject>Swelling</subject><issn>1053-1807</issn><issn>1522-2586</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp90ElLxDAYxvEgivvFDyABLyJU36xNjzLuuOFy8VLSzlsmQ5cxaRW_vRlHPXjwlBx-_Hl5CNlhcMgA-NG08e6Qm1TIJbLOFOcJV0Yvxz8okTAD6RrZCGEKAFkm1SpZEykobjisk5fTqsKyp11Fz7FFb2t63GLoJxicpV1Lbx7o3ax3Jb1F_4b0cYK2n9ATZxvs0VPX0mjpPY6d7X1k991sqG3vunaLrFS2Drj9_W6S57PTp9FFcn13fjk6vk5KwbRMECoFRiFYWY2lEqCkAVsUqARPZQkF1xZKphiX4zLTUhtA4CIThdCFZpnYJPuL7sx3r0O8PW9cKLGubYvdEHJuADRPU5FGuveHTrvBt_G6qIzOUgA5Dx4sVOm7EDxW-cy7xvqPnEE-XzyfL55_LR7x7ndyKBoc_9KfiSNgC_Duavz4J5Vf3TxcLqKfbVKIrQ</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Cohen, Israel</creator><creator>Kraus, Matan</creator><creator>Greenberg, Gahl</creator><creator>Hoffmann, Chen</creator><creator>Shrot, Shai</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8954-3244</orcidid></search><sort><creationdate>202312</creationdate><title>Effect of General Anesthesia on MR Optic Nerve Sheath Diameter in the Pediatric Population</title><author>Cohen, Israel ; Kraus, Matan ; Greenberg, Gahl ; Hoffmann, Chen ; Shrot, Shai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3164-e0f5085e0a4fd45305480abbe53274c0b26a0c15124dc964680e02393b36b6193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anesthesia</topic><topic>Brain</topic><topic>Cerebrospinal fluid</topic><topic>children</topic><topic>Correlation coefficient</topic><topic>Correlation coefficients</topic><topic>Diameters</topic><topic>Distension</topic><topic>Field strength</topic><topic>General anesthesia</topic><topic>intracranial hypertension</topic><topic>Intracranial pressure</topic><topic>Magnetic resonance imaging</topic><topic>Mechanical ventilation</topic><topic>Medical imaging</topic><topic>MRI</topic><topic>Nerves</topic><topic>Neuroimaging</topic><topic>Optic nerve</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Population studies</topic><topic>pseudotumor cerebri</topic><topic>sedation</topic><topic>Sheaths</topic><topic>Statistical analysis</topic><topic>Statistical tests</topic><topic>Subarachnoid space</topic><topic>Subgroups</topic><topic>Swelling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cohen, Israel</creatorcontrib><creatorcontrib>Kraus, Matan</creatorcontrib><creatorcontrib>Greenberg, Gahl</creatorcontrib><creatorcontrib>Hoffmann, Chen</creatorcontrib><creatorcontrib>Shrot, Shai</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of magnetic resonance imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cohen, Israel</au><au>Kraus, Matan</au><au>Greenberg, Gahl</au><au>Hoffmann, Chen</au><au>Shrot, Shai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of General Anesthesia on MR Optic Nerve Sheath Diameter in the Pediatric Population</atitle><jtitle>Journal of magnetic resonance imaging</jtitle><addtitle>J Magn Reson Imaging</addtitle><date>2023-12</date><risdate>2023</risdate><volume>58</volume><issue>6</issue><spage>1875</spage><epage>1881</epage><pages>1875-1881</pages><issn>1053-1807</issn><eissn>1522-2586</eissn><abstract>Background
Papilledema is thought to be the hallmark sign of increased intracranial pressure (ICP). Distension of the subarachnoid space within the optic nerve sheath is also commonly reported in MR studies as an indirect sign of increased ICP.
Hypothesis
General anesthesia and positive pressure ventilation might result in changes in optic sheath diameter (OSD) observed on clinical brain MRI.
Study Type
Retrospective.
Population
One hundred forty‐five patients (154 MRI scans, 7.3 years ± 5.1); 97 studies in the anesthesia group (4.4 years ± 3.4) of which 22 had papilledema, and 57 in the non‐anesthesia group (12.3 years ± 3.2), of which 28 had papilledema.
Field Strength/Sequence
1.5T or 3.0T volumetric T2 images. T2 images were obtained from different vendors.
Assessment
OSD, optic nerve diameter (OND), and peri‐optic cerebrospinal fluid (CSF) were measured manually on T2‐weighted MR images for various population subgroups (with and without anesthesia; with or without papilledema). The correlation between these measurements and the clinical diagnosis of papilledema was evaluated via receiver operating characteristic (ROC) analysis.
Statistical Tests
Chi‐square test; Mann–Whitney Test; Spearman's test and ROCs; Interclass correlation coefficient, P = 0.05.
Results
General anesthesia resulted in significantly larger mean OSD in patients with or without papilledema (7.3 ± 1.0 mm vs. 6.1 ± 1.1 mm and 6.7 ± 1.0 mm vs. 5.4 ± 0.9 mm, respectively). In the non‐anesthesia group, the average OSD values (6.1 ± 1.1 mm) were significantly higher in papilledema patients compared to non‐papilledema patients (5.4 ± 0.9 mm), with larger peri‐optic CSF rim (1.6 ± 0.4 mm vs. 1.3 ± 0.3 mm). In the anesthesia group, OND was significantly larger in papilledema patients (3.4 ± 0.4 mm vs. 3.1 ± 0.5 mm), though the average peri‐optic CSF rim did not reach a significance in papilledema compared with non‐papilledema patients (2.0 ± 0.3 mm vs. 1.8 ± 0.4 mm, P = 0.06). In patients with general anesthesia, peri‐optic CSF rim had a limited correlation with increased ICP.
Data Conclusion
In the pediatric population, imaging findings of increased OSD on brain MRI might be related to general anesthesia rather than increased ICP. The interpretation of optic nerve sheath distention should be reported cautiously in conjunction with anesthesia status, especially in the pediatric population.
Evidence Level: 4
Technical Efficacy: 5</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>37052820</pmid><doi>10.1002/jmri.28734</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8954-3244</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library All Journals |
| subjects | Anesthesia Brain Cerebrospinal fluid children Correlation coefficient Correlation coefficients Diameters Distension Field strength General anesthesia intracranial hypertension Intracranial pressure Magnetic resonance imaging Mechanical ventilation Medical imaging MRI Nerves Neuroimaging Optic nerve Patients Pediatrics Population studies pseudotumor cerebri sedation Sheaths Statistical analysis Statistical tests Subarachnoid space Subgroups Swelling |
| title | Effect of General Anesthesia on MR Optic Nerve Sheath Diameter in the Pediatric Population |
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