Background Optic nerve ultrasonography (optic nerve sheath diameter sonography) has been proposed as a noninvasive, quick method for diagnosing increased intracranial pressure. Purpose To examine the accuracy of optic nerve ultrasonography for diagnosing increased intracranial pressure in children and adults. Data Sources 13 databases from inception through May 2019, reference lists, and meeting proceedings. Study Selection Prospective optic nerve ultrasonography diagnostic accuracy studies, published in any language, involving any age group or reference standard. Data Extraction 3 reviewers independently abstracted data and performed quality assessment. Data Synthesis Of 71 eligible studies involving 4551 patients, 61 included adults, and 35 were rated as having low risk of bias. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of optic nerve ultrasonography in patients with traumatic brain injury were 97% (95% CI, 92% to 99%), 86% (CI, 74% to 93%), 6.93 (CI, 3.55 to 13.54), and 0.04 (CI, 0.02 to 0.10), respectively. Respective estimates in patients with nontraumatic brain injury were 92% (CI, 86% to 96%), 86% (CI, 77% to 92%), 6.39 (CI, 3.77 to 10.84), and 0.09 (CI, 0.05 to 0.17). Accuracy estimates were similar among studies stratified by patient age, operator specialty and training level, reference standard, sonographer blinding status, and cutoff value. The optimal cutoff for optic nerve sheath dilatation on ultrasonography was 5.0 mm. Limitation Small studies, imprecise summary estimates, possible publication bias, and no evaluation of effect on clinical outcomes. Conclusion Optic nerve ultrasonography can help diagnose increased intracranial pressure. A normal sheath diameter measurement has high sensitivity and a low negative likelihood ratio that may rule out increased intracranial pressure, whereas an elevated measurement, characterized by a high specificity and positive likelihood ratio, may indicate increased intracranial pressure and the need for additional confirmatory tests. Primary Funding Source None. (PROSPERO: CRD42017055485).

中文翻译：

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用于诊断颅内压增高的床旁光学神经超声检查：系统评价和荟萃分析。

背景技术已经提出了视神经超声检查（视神经鞘管直径超声检查）作为诊断颅内压增高的一种非侵入性快速方法。目的探讨视神经超声检查在诊断儿童和成人颅内压增高中的准确性。数据来源13个数据库，涵盖从成立到2019年5月的所有内容，参考列表和会议记录。研究选择前瞻性视神经超声诊断准确性研究，以任何语言出版，涉及任何年龄组或参考标准。数据提取3位审阅者独立提取数据并进行质量评估。数据综合71项涉及4551例患者的合格研究，其中61例包括成人，其中35例被评估为偏倚风险低。合并的敏感性，特异性，正似然比，脑外伤的视神经超声检查阴性率和阴性可能性分别为97％（95％CI，92％至99％），86％（CI，74％至93％），6.93（CI，3.55至13.54），和0.04（CI，0.02到0.10）。非创伤性脑损伤患者的分别估计为92％（CI，86％至96％），86％（CI，77％至92％），6.39（CI，3.77至10.84）和0.09（CI，0.05至0.17） ）。在按患者年龄，操作员专业和培训水平，参考标准，超声医师盲目状态和临界值进行分层的研究中，准确性估计值相似。超声检查视神经鞘管扩张的最佳截止值为5.0 mm。局限性小型研究，不准确的摘要估计，可能的出版偏倚以及未评估对临床结局的影响。结论视神经超声检查有助于诊断颅内压升高。正常的鞘管直径测量具有较高的灵敏度和较低的负似然比，可以排除颅内压升高，而以较高的特异性和阳性似然比为特征的升高的测量值可能表明颅内压升高，并且需要进行额外的验证性测试。主要资金来源无。（PROSPERO：CRD42017055485）。主要资金来源无。（PROSPERO：CRD42017055485）。主要资金来源无。（PROSPERO：CRD42017055485）。