Analysis of Neuroradiologic Findings in Idiopathic Intracranial Hypertension-A Population-Based Study.

Autor:	Steinberg YN; Albert Einstein College of Medicine Training Program (YNS), Bronx, New York; Department of Ophthalmology (YNS), Boston University, Boston, Massachusetts; Department of Radiology (GJP), Jacobi Medical Center, Bronx, New York; Department of Radiology (GJP), Albert Einstein College of Medicine, Bronx, New York; Department of Ophthalmology and Visual Sciences (NKR), Montefiore Medical Center, Bronx, New York; Department of Ophthalmology (NR), New York Eye and Ear Infirmary of Mt Sinai, New York, New York; Department of Medicine (FMPS), Jacobi Medical Center, Bronx, New York; Department of Ophthalmology (FMPS), Indiana University School of Medicine, Indianapolis, Indiana; Department of Research Studies (AP), University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery (Ophthalmology) (JNM), Jacobi Medical Center, Bronx, New York; and Department of Ophthalmology and Visual Sciences (JNM), Albert Einstein College of Medicine, Bronx, New York., Parnes GJ, Raval NK, Pellerano Sosa FM, Parsikia A, Mbekeani JN
Jazyk:	angličtina
Zdroj:	Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society [J Neuroophthalmol] 2024 Sep 05. Date of Electronic Publication: 2024 Sep 05.
DOI:	10.1097/WNO.0000000000002248
Abstrakt:	Background: Idiopathic intracranial hypertension (IIH) has been associated with several MRI features. We assessed types of MRI findings and clinical-radiologic correlations in patients with IIH from one hospital system. Methods: A retrospective chart review of IIH and control patients was conducted. Brain MRI/magnetic resonance venogram features were enumerated and assessed for correlation with body mass index (BMI) and lumbar puncture opening pressure (LPOP). Sensitivity, specificity, positive predictive value (PPV), and likelihood ratios (LRs) were calculated for each MRI sign. Significance was set at P < 0.05. Results: One hundred one patients diagnosed with IIH, and 119 control patients had complete files and were included. Patients with IIH were predominantly female (92.8% vs 59.7%; P = <0.001), younger (30.6 years vs 46.4 years; P < 0.001), and more obese (mean BMI = 35.2 vs 29.3; P < 0.001) than controls. Mean (SD) number of MRI findings was 2.21 (1.8) in IIH and 0.6 (1.2) in controls; (P < 0.001). Vertical nerve tortuosity (44.1%; P < 0.001), TVSS (37.8%; P < 0.001), sheath expansion (36.0%; P < 0.001), globe flattening (22.5%; P < 0.001), slit ventricles (18.9%; P < 0.001), optic disc protrusion (9.9%; P = 0.007), and complete empty sella (12.6%; P < 0.042) were observed more in patients with IIH than control patients. In the IIH group, mean (SD) LPOP was 33.6 (11.11) cmH2O and weakly correlated with number of MRI findings (rho = 0.182, P = 0.057). TVSS (sensitivity 37.84%; confidence interval [CI] 29.3%-47.2%, specificity 98.32%; CI 93.5%-99.6%) had the highest PPV (95.45%) and positive LR (22.51) for IIH diagnosis. Conclusions: These results are consistent with IIH predominance in young, obese females. In patients with IIH, the number of MRI findings exceeded controls and positively correlated with LPOP. TVSS was most predictive of IIH. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 by North American Neuro-Ophthalmology Society.)
Databáze:	MEDLINE
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