Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
권호 표지
DOI QR코드

DOI QR Code

Assessment of Posterior Globe Flattening: Two-Dimensional versus Three-Dimensional T2-Weighted Imaging

  • Ann, Jun Hyung (Department of Radiology, Gachon University Gil Medical Center) ;
  • Kim, Eung Yeop (Department of Radiology, Gachon University Gil Medical Center)
  • Received : 2015.08.31
  • Accepted : 2015.09.22
  • Published : 2015.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To compare the frequency of posterior globe flattening between two-dimensional T2-weighted imaging (2D T2WI) and three-dimensional (3D T2WI). Materials and Methods: Sixty-nine patients (31 female; mean age, 44.4 years) who had undergone both 5-mm axial T2WI and sagittal 3D 1-mm isovoxel T2WI of the whole brain for evaluation of various diseases (headache [n = 30], large hemorrhage [n = 19], large tumor or leptomeningeal tumor spread [n = 15], large infarct [n = 3], and bacterial meningitis [n = 2]) were used in this study. Two radiologists independently reviewed both sets of images at separate sessions. Axial T2WI and multi-planar imaging of 3D T2WI were visually assessed for the presence of globe flattening. The optic nerve sheath diameter (ONSD) was measured at a location 4 mm posterior to each globe on oblique coronal imaging reformatted from 3D T2WI. Results: There were significantly more globes showing posterior flattening on 3D T2WI (105/138 [76.1%]) than on 2D T2WI (27/138 [19.6%], P = 0.001). Inter-observer agreement was excellent for both 2D T2WI and 3D T2WI (Cohen's kappa = 0.928 and 0.962, respectively). Intra-class correlation coefficient for the ONSD was almost perfect (Cohen's kappa = 0.839). The globes with posterior flattening had significantly larger ONSD than those without on both 2D and 3D T2WI (P < 0.001; $6.14mm{\pm}0.44$ vs. $5.74mm{\pm}0.44$ on 2D T2WI; $5.90mm{\pm}0.47$ vs. $5.56mm{\pm}0.34$ on 3D T2WI). Optic nerve protrusion was significantly more frequent on reformatted 1-mm 3D T2WI than on 5-mm 2D T2WI (8 out of 138 globes on 3D T2WI versus one on 2D T2WI; P = 0.018). Conclusion: Posterior globe flattening is more frequently observed on 3D T2WI than on 2D T2WI in patients suspected of having increased intracranial pressure. The globes with posterior flattening have significantly larger ONSD than those without.

Keywords

References

  1. Ball AK, Clarke CE. Idiopathic intracranial hypertension. Lancet Neurol 2006;5:433-442 https://doi.org/10.1016/S1474-4422(06)70442-2
  2. Binder DK, Horton JC, Lawton MT, McDermott MW. Idiopathic intracranial hypertension. Neurosurgery 2004;54:538-551; discussion 551-532 https://doi.org/10.1227/01.NEU.0000109042.87246.3C
  3. Rohr AC, Riedel C, Fruehauf MC, et al. MR imaging findings in patients with secondary intracranial hypertension. AJNR Am J Neuroradiol 2011;32:1021-1029 https://doi.org/10.3174/ajnr.A2463
  4. Skau M, Brennum J, Gjerris F, Jensen R. What is new about idiopathic intracranial hypertension? An updated review of mechanism and treatment. Cephalalgia 2006;26:384-399 https://doi.org/10.1111/j.1468-2982.2005.01055.x
  5. Algahtani HA, Baeesa SS, Obeid TH, Abuzinadah AR. Idiopathic intracranial hypertension. Atypical presentation. Saudi Med J 2007;28:762-765
  6. Brodsky MC, Vaphiades M. Magnetic resonance imaging in pseudotumor cerebri. Ophthalmology 1998;105:1686-1693 https://doi.org/10.1016/S0161-6420(98)99039-X
  7. Digre KB, Nakamoto BK, Warner JE, Langeberg WJ, Baggaley SK, Katz BJ. A comparison of idiopathic intracranial hypertension with and without papilledema. Headache 2009;49:185-193 https://doi.org/10.1111/j.1526-4610.2008.01324.x
  8. Hansen HC, Helmke K. Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J Neurosurg 1997;87:34-40 https://doi.org/10.3171/jns.1997.87.1.0034
  9. Watanabe A, Kinouchi H, Horikoshi T, Uchida M, Ishigame K. Effect of intracranial pressure on the diameter of the optic nerve sheath. J Neurosurg 2008;109:255-258 https://doi.org/10.3171/JNS/2008/109/8/0255
  10. Steffen H, Eifert B, Aschoff A, Kolling GH, Volcker HE. The diagnostic value of optic disc evaluation in acute elevated intracranial pressure. Ophthalmology 1996;103:1229-1232 https://doi.org/10.1016/S0161-6420(96)30518-6
  11. Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G. Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology 2006;48:521-527 https://doi.org/10.1007/s00234-006-0095-y
  12. Sotoudeh H, Bowerson M, Parsons M, et al. Effect of spatial resolution of T2-weighted imaging on diagnostic efficacy of MRI in detection of papilledema. AJR Am J Roentgenol 2015;204:602-607 https://doi.org/10.2214/AJR.14.12662
  13. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-174 https://doi.org/10.2307/2529310
  14. Hayreh SS. Pathogenesis of Oedema of the Optic Disc (Papilloedema). A Preliminary Report. Br J Ophthalmol 1964;48:522-543 https://doi.org/10.1136/bjo.48.10.522
  15. Friedman DI. The pseudotumor cerebri syndrome. Neurol Clin 2014;32:363-396 https://doi.org/10.1016/j.ncl.2014.01.001
  16. Friedman DI, Jacobson DM. Diagnostic criteria for idiopathic intracranial hypertension. Neurology 2002;59:1492-1495 https://doi.org/10.1212/01.WNL.0000029570.69134.1B
  17. Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013;81:1159-1165 https://doi.org/10.1212/WNL.0b013e3182a55f17
  18. Seitz J, Held P, Strotzer M, et al. Magnetic resonance imaging in patients diagnosed with papilledema: a comparison of 6 different high-resolution T1- and T2(*)-weighted 3-dimensional and 2-dimensional sequences. J Neuroimaging 2002;12:164-171 https://doi.org/10.1111/j.1552-6569.2002.tb00115.x
  19. Alperin N, Bagci AM, Lam BL, Sklar E. Automated quantitation of the posterior scleral flattening and optic nerve protrusion by MRI in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 2013;34:2354-2359 https://doi.org/10.3174/ajnr.A3600