Value analysis of the combination of optic nerve sheath ultrasound and transcranial Doppler ultrasound in the assessment of ischemic stroke

Wang Ruiqiong; Rao Shuangshuang; Wu Liyue

doi:10.11850/j.issn.1009-122X.2023.12.020

Abstract：Objective To analyze the evaluation value of combined detection of optic nerve sheath ultrasound and transcranial Doppler ultrasound in ischemic stroke patients.Methods A total of 80 suspected ischemic stroke patients were included and underwent transcranial Doppler ultrasound examination and optic nerve sheath ultrasound examination.Cerebrovascular angiography was used as the gold standard for disease diagnosis.The diagnostic efficacy of the two methods alone and combined was compared,the detection rate of different parts and different degrees of cerebral artery stenosis,and the ultrasound signs of healthy patients with ischemic stroke were compared.Results There was no difference in diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value between transcranial Doppler ultrasonography and optic nerve vaginalis ultrasonography(P>0.05).The diagnostic efficacy of combined ultrasonography was 95.24%,92.11%,93.75%,93.02%and 94.59%,respectively,which was significantly higher than that of single ultrasonography.There was significant difference in comparison between groups(P<0.05).The total detection rate of transcranial Doppler ultrasonography combined with optic nerve sheathing ultrasonography for middle cerebral artery stenosis,anterior artery stenosis,posterior cerebral artery stenosis,internal carotid artery stenosis,basilar artery stenosis and vertebral artery stenosis was 95.83%,which was significantly higher than that of transcranial Doppler ultrasonography(P<0.05).The total detection rate of arterial stenosis in different degrees(mild,moderate,severe,and complete occlusion)by optic nerve sheath ultrasound plus transcranial Doppler ultrasound was 93.75%,higher than that by transcranial Doppler ultrasound alone,with a significant intergroup difference(P<0.05).The mean systolic blood flow velocity in ischemic stroke patients was(59.96±7.45)cm/s,the mean blood flow velocity was(38.54±3.12)cm/s,and the diastolic blood flow velocity was(24.48±4.27)cm/s,which was significantly lower than that of normal people(136.18±14.32)cm/s,(85.21±5.68)cm/s,and(60.72±3.96)cm/s,respectively.The optic nerve sheath diameter was(5.12±0.58)mm,and the intracranial pressure was(22.72±3.45)mmHg,which was higher than that of normal people(4.32±0.44)mm and(10.32±1.15)mmHg,respectively,with significant intergroup differences(P<0.05).Conclusions Transcranial Doppler ultrasound combined with optic nerve sheathing ultrasound can accurately diagnose severe ischemic stroke,and can also detect the location and degree of stenosis.