医学影像学杂志

目的 探讨经超声测量视神经鞘直径（ONSD）与子痫前期孕妇颅内压（ICP）增高的相关性。方法 选取子痫前期孕妇60例，根据MRI检查结果将其分为ICP增高组（19例）和ICP正常组（41例），选取同期在本院正常产检的孕妇35例（对照组）。经超声测量各组ONSD，采用Pearson相关系数分析经超声检查测量ONSD与子痫前期孕妇ICP增高的相关性。采用受试者工作特征（ROC）曲线下面积（AUC）分析子痫前期孕妇双眼ONSD，判断ICP增高的诊断阈值及其价值。结果 ICP增高组双眼ONSD均明显高于ICP正常组和对照组，差异有统计学意义（P<0.05）,ICP正常组双眼ONSD与对照组比较，差异无统计学意义（P>0.05）。子痫前期孕妇双眼ONSD均与ICP呈正相关（r分别为0.794、0.820,P<0.05）。诊断子痫前期孕妇ICP增高，双眼ONSD的AUC分别为0.827、0.832(P<0.05)。结论 ICP可能会影响ONSD变化，子痫前期ICP增高的孕妇ONSD明显高于ICP未增高者，在子痫前期孕妇中利用超声检查测量ONSD对诊断ICP增高有一定临床价值。

Objective To investigate the correlation between the optic nerve sheath diameter(ONSD) measured by ultrasound and the increase of intracranial pressure(ICP) in patients with preeclampsia. Methods A total of 60 preeclampsia patients admitted to our hospital were selected as the observation group, 35 pregnant women who underwent normal antenatal examination in our hospital in the same period were included as the control group. According to the results of MRI, the patients with preeclampsia were divided into an increased ICP group(n=19) and a normal ICP group(n=41). The ONSD level of each group was measured by ultrasound, and the Pearson correlation coefficient analysis was used to analyze the ONSD and preeclampsia measured by ultrasound. The correlation of patients with increased ICP. The diagnostic threshold and its value of left and right eye ONSD in preeclampsia were analyzed by AUC of ROC curve. Results The levels of ONSD in both eyes of the increased ICP group were significantly higher than those of the normal ICP group and the control group(P<0.05). There was no significant difference in ONSD levels between the normal ICP group and the control group(P>0.05). The levels of ONSD in the left and right eyes of patients with preeclampsia were positively correlated with ICP(r=0.794, 0.820, P<0.05). The AUC values of increased ICP in patients with preeclampsia diagnosed by ONSD in the left eye and ONSD in the right eye were 0.827 and 0.832, respectively(P<0.05). Conclusion ICP may affect the changes of ONSD. The ONSD value of patients with increased ICP in preeclampsia is significantly higher than that of those without increased ICP. And ultrasonic measurement of ONSD has certain clinical value in diagnosing increased ICP in preeclampsia.