Comparative analysis of intracranial pressure prediction models using optic nerve sheath diameter and additional ultrasound metrics
5 affiliations
- 1Department of Neurology, The Second Hospital of Shanxi Medical University
- 2Department of Neurology, The First Hospital of Shanxi Medical University
- 3Department of Neurosurgery, The First Hospital of Shanxi Medical University
- 4The First Department of Clinical Medicine, Shanxi Medical University
- 5Department of Neurorehabilitation, Affiliated Hospital of Shanxi Provincial Rehabilitation Research Center
Abstract
Optic nerve sheath diameter (ONSD) assessment of elevated intracranial pressure is increasingly emphasised as a noninvasive modality. Nevertheless, quantitative assessment remains limited, and study criteria vary. We constructed four prediction models based on ONSD and compared their accuracy in predicting intracranial pressure (ICP). Changes in the ONSD during the normalization of intracranial pressure in patients with increased intracranial pressure were investigated. We recruited 220 patients who completed lumbar puncture (LP) (model groups, n = 154; test groups, n = 66). Sixty-six patients with increased intracranial pressure were successfully followed up. Four mathematical equations were established in the model group (n = 154): 1. the ONSD combined OND model: predicted ICP = 10.236 × ONSD–7.986 × OND–20.151; 2. ONSD model: predicted ICP = 7.966 × ONSD – 29.62; 3. ΔONSD model: predicted ICP = 10.32 × ΔONSD-14.45; 4. ONSD/ETD model: predicted ICP = 119.5 × ONSD/ETD-14.48. In the test group (n = 66), the ONSD combined OND model achieved the largest ICC (0.89), showing better predictive consistency. During follow-up, in patients with intracranial pressure exceeding 20 mmHg, ROC analysis indicated ONSD > 5.83 mm and ΔONSD > 3.21 mm could act as potential screening cut-offs for ICP > 20 mmHg. Bedside ultrasound ONSD combined with OND may serve as a supplementary non-invasive ICP assessment method. The ONSD combined OND model and the ΔONSD models outperformed single ONSD prediction, which may suggest ICP fluctuation influences the optic nerve sheath more prominently than the optic nerve. It should be noted that when the ONSD combined OND indicators to evaluate the therapeutic effect in patients with intracranial hypertension,the higher the intracranial pressure, the slower the recovery of OND, and this asynchronous phenomenon must be considered.
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BibTeX
@article{cheng2026comparative,
title = {{Comparative analysis of intracranial pressure prediction models using optic nerve sheath diameter and additional ultrasound metrics}},
author = {Mingqing Cheng and Tingting Liu and Geng Guo and Zili Hui and Lei Zhang and Jianqiang Hu and Yalan Fang and Xin Zhang},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-63094-x},
url = {https://doi.org/10.1038/s41598-026-63094-x},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative analysis of intracranial pressure prediction models using optic nerve sheath diameter and additional ultrasound metrics
AU - Mingqing Cheng
AU - Tingting Liu
AU - Geng Guo
AU - Zili Hui
AU - Lei Zhang
AU - Jianqiang Hu
AU - Yalan Fang
AU - Xin Zhang
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-63094-x
UR - https://doi.org/10.1038/s41598-026-63094-x
AB - Optic nerve sheath diameter (ONSD) assessment of elevated intracranial pressure is increasingly emphasised as a noninvasive modality. Nevertheless, quantitative assessment remains limited, and study criteria vary. We constructed four prediction models based on ONSD and compared their accuracy in predicting intracranial pressure (ICP). Changes in the ONSD during the normalization of intracranial pressure in patients with increased intracranial pressure were investigated. We recruited 220 patients who completed lumbar puncture (LP) (model groups, n = 154; test groups, n = 66). Sixty-six patients with increased intracranial pressure were successfully followed up. Four mathematical equations were established in the model group (n = 154): 1. the ONSD combined OND model: predicted ICP = 10.236 × ONSD–7.986 × OND–20.151; 2. ONSD model: predicted ICP = 7.966 × ONSD – 29.62; 3. ΔONSD model: predicted ICP = 10.32 × ΔONSD-14.45; 4. ONSD/ETD model: predicted ICP = 119.5 × ONSD/ETD-14.48. In the test group (n = 66), the ONSD combined OND model achieved the largest ICC (0.89), showing better predictive consistency. During follow-up, in patients with intracranial pressure exceeding 20 mmHg, ROC analysis indicated ONSD > 5.83 mm and ΔONSD > 3.21 mm could act as potential screening cut-offs for ICP > 20 mmHg. Bedside ultrasound ONSD combined with OND may serve as a supplementary non-invasive ICP assessment method. The ONSD combined OND model and the ΔONSD models outperformed single ONSD prediction, which may suggest ICP fluctuation influences the optic nerve sheath more prominently than the optic nerve. It should be noted that when the ONSD combined OND indicators to evaluate the therapeutic effect in patients with intracranial hypertension,the higher the intracranial pressure, the slower the recovery of OND, and this asynchronous phenomenon must be considered.
SN - 2045-2322
ER -