{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:28:32Z","timestamp":1789140512526,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2022,1]]},"abstract":"Abstract<\/jats:title>\n \n Background and Purpose<\/jats:title>\n Treatment of elevated intracranial pressure (ICP) is central to neurocritical care, but not all patients are eligible for invasive ICP\u2010monitoring. A promising noninvasive option is ultrasound measurement of the optic nerve sheath diameter (ONSD). However, meta\u2010analyses of ONSD for elevated ICP show wide confidence intervals. This might be due to baseline variations, inter\u2010rater variability, and varying measurement methods. No standardized protocol has been validated. Corrections for eyeball diameter (ED) and optic nerve diameter (OND) may compensate for baseline variations. We evaluated a protocol and compared two different measurement methods for ONSD ultrasound.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Two operators, blinded to each other's measurements, measured ONSD, ED, and OND twice in 20 patients. ONSD was measured with two different methods in use: internal (ONSDint) or external (ONSDext) of the dura mater. Intra\u2010class correlation (ICC) was calculated for inter\u2010rater and intra\u2010rater reliability.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n ICCs for inter\u2010rater reliability of ONSDext and ONSDint (95% confidence interval) were 0.96 (0.93, 0.98) and 0.88 (0.79, 0.94), respectively. ICCs for intra\u2010rater reliability of ONSDext and ONSDint were 0.97 (0.94, 0.99) and 0.93 (0.87, 0.96), respectively. There was no significant bias or difference in intra\u2010rater reliability between operators.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n ONSD can be measured with an excellent inter\u2010 and intra\u2010rater reliability and low risk of inter\u2010rater bias, when using this protocol. ONSDext yields a higher inter\u2010 and intra\u2010rater reliability than ONSDint. Corrections for ED and OND can be performed reliably.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jon.12936","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T12:46:04Z","timestamp":1632401164000},"page":"104-110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Optic nerve sheath diameter measurement by ultrasound: Evaluation of a standardized protocol"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6665-0589","authenticated-orcid":false,"given":"Jakob","family":"Pansell","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"},{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital Stockholm Sweden"},{"name":"Department of Physiology & Pharmacology Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rudberg","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital Stockholm Sweden"},{"name":"Department of Physiology & Pharmacology Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Friman","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charith","family":"Cooray","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"},{"name":"Department of Clinical Neurophysiology Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,23]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"CD002043","article-title":"Routine intracranial pressure monitoring in acute coma","volume":"2015","author":"Forsyth RJ","year":"2015","journal-title":"Cochrane Database Syst 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