İdyopatik intrakranyal hipertansiyonda kranyal MRG bulgularının kantitatif değerlendirilmesi

Year 2025, Volume: 8 Issue: 5, 859 - 864, 16.09.2025

Fatma Kökcü

https://doi.org/10.32322/jhsm.1681670

Abstract

Amaç: İdyopatik intrakranyal hipertansiyon (İİH) intrakranyal basınç artışı ile karakterize bir sendromdur. Bu çalışma ile İİH’ da kranyal MRG bulgularının kantitatif değerlerini vererek tanı doğruluğunu artırmak amaçlanmıştır.
Yöntemler: Bu çalışmaya İİH tanısı alan 37 hasta ile yaş, cinsiyet eşleştirme tekniği kullanılarak seçilmiş 22 kontrol katılımcı dahil edildi. Çalışmada optik sinir kılıfı çapı (OSKÇ), optik sinir çapı (OSÇ,) meckel kovuğu çapı (MKÇ), süperior sagital sinüs kesitsel alanı( SSSA), sağ ve sol transvers sinüs alanı (TSA), sağ lateral ventrikül frontal hornu transvers çapı (LVFHÇ), sella kavitesinin A-P çapı ve vertikal yüksekliği, hipofizin vertikal uzunluğu (HVU)ölçüldü. Cut off değerleri için ROC analizi uygulandı.

Bulgular: Hasta ve kontrol grubu arasında OSKÇ, MKÇ, SSSA, TSA, sella A-P çapı, HVU, ve dural sinüs hipoplazisi yönünden istatistiksel anlamlı farklılık mevcuttu. LVFHÇ, OSÇ değerleri arasında ise istatisiksel anlamlı farklılık yoktu. OSKÇ 0.996 AUC değeri ve 6.4 cut off değeri ile İİH hastalarının kontrollerden ayırıcı tanısında en güvenilir belirteç olarak saptandı.
Sonuç: Bu çalışmada OSKÇ, MKÇ, Sella A-P çapı ve HVU, sella vertikal uzunluğu ve SSSA'yı ölçerek İİH tanısına ve tedavi sonrası takip sürecine önemli katkı sağlayabileceğini düşünüyoruz.

Keywords

İdyopatik İntrakranyal Hipertansiyon , Manyetik Rezonans Görüntüleme , kantitatif değerlendirme

Quantitative evaluation of cranial MRI findings in idiopathic intracranial hypertension

Abstract

Aims: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by intracranial pressure. The purpose of this study was to evaluate the accuracy of diagnosis by giving the quantitative values of imaging findings of IIH on cranial MRI.
Methods: This study included 37 patients who were diagnosed with IIH and 22 healthy controls were included by using a match-to-pair technique regarding their sex and age. Optic nerve sheath diameter (ONSD) and optic nerve diameter (OND), transverse diameter of Meckel cave (MCD), superior sagittal sinus area (SSSA), right and left transverse sinus area (RTSA, LTSA), transverse diameter of right lateral ventricle frontal horn (LVFHD), vertical length and A-P diameter of sella cavity, vertical length of pituitary gland (VLPG) were measured. ROC analysis was performed for the cut off values.
Results: There was statistically significant difference between patient group and control group in terms of ONSD, MCD, SSSA, RTSA, LTSA sella cavity A-P diameter, VLPG vertical length of sella and hypoplasia of dural venous sinus. On the other hand, there was no statistically significant difference between the patient and the control groups regarding LVFHD, OND. ONSD showed an AUC of 0.996 with a cutoff value of 6.4 mm >=, it was found to be highest reliable marker in the differential diagnosis of IIH patients from the controls.
Conclusion: We believe that this study can an important contribution to the diagnosis IIH and follow-up period after its treatment by measuring ONSD, MCD, Sella A-P and VLPG, vertical length of sella and SSSA.

Keywords

Idiopathic intracranial hypertension , magnetic resonance imaging , quantitative evaluation

References

• Hoffmann J, Schmidt C, Kunte H, et al. Volumetric assessment of optic nerve sheath and hypophysis in idiopathic intracranial hypertension. AJNR Am J Neuroradiol. 2014;35(3):513-518. doi:10.3174/ajnr.A3694
• Bénard-Séguin É, Costello F. Idiopathic intracranial hypertension with papilledema. Neurosurg Clin N Am. 2025;36(2):281-298. doi:10.1016/j.nec.2024.12.001
• Zhou C, Zhou Y, Liu L, et al. Progress and recognition of idiopathic intracranial hypertension: a narrative review. CNS Neurosci Ther. 2024; 30(8):e14895. doi:10.1111/cns.14895
• Mathew NT, Ravishankar K, Sanin LC. Coexistence of migraine and idiopathic intracranial hypertension without papilledema. Neurology. 1996;46(5):1226-1230. doi:10.1212/wnl.46.5.1226
• Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G. Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology. 2006;48(8):521-527. doi:10.1007/s00234-006-0095-y
• Brodsky MC, Vaphiades M. Magnetic resonance imaging in pseudotumor cerebri. Ophthalmology. 1998;105(9):1686-1693. doi:10. 1016/S0161-6420(98)99039-X
• Manfré L, Lagalla R, Mangiameli A, et al. Idiopathic intracranial hypertension: orbital MRI. Neuroradiology. 1995;37(6):459-461. doi:10. 1007/BF00600093
• Gibby WA, Cohen MS, Goldberg HI, Sergott RC. Pseudotumor cerebri: CT findings and correlation with vision loss. AJR Am J Roentgenol. 1993; 160(1):143-146. doi:10.2214/ajr.160.1.8416612
• Acheson JF. Idiopathic intracranial hypertension and visual function. Br Med Bull. 2006;79-80:233-244. doi:10.1093/bmb/ldl019
• Rohr A, Bindeballe J, Riedel C, et al. The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study. Neuroradiology. 2012;54(1):25-33. doi:10.1007/s00234-011-0850-6
• Ball AK, Clarke CE. Idiopathic intracranial hypertension. Lancet Neurol. 2006;5(5):433-442. doi:10.1016/S1474-4422(06)70442-2
• Bialer OY, Rueda MP, Bruce BB, Newman NJ, Biousse V, Saindane AM. Meningoceles in idiopathic intracranial hypertension. AJR Am J Roentgenol. 2014;202(3):608-613. doi:10.2214/AJR.13.10874
• San Millán D, Kohler R. Enlarged CSF spaces in pseudotumor cerebri. AJR Am J Roentgenol. 2014;203(4):W457-W458. doi:10.2214/AJR.14. 12787
• Degnan AJ, Levy LM. Narrowing of Meckel’s cave and cavernous sinus and enlargement of the optic nerve sheath in Pseudotumor Cerebri. J Comput Assist Tomogr. 2011;35(2):308-312. doi:10.1097/RCT.0b013e318 20d7a70
• Balık AÖ, Akıncı O, Yıldız S, Hasırcı Bayır BR, Ulutaş C. Role of neuroimaging markers on predicting of idiopathic intracranial hypertension. Acta Radiol. 2024;65(8):999-1006. doi:10.1177/0284185124 1256008
• Kyung SE, Botelho JV, Horton JC. Enlargement of the sella turcica in pseudotumor cerebri. J Neurosurg. 2014;120(2):538-542. doi:10.3171/ 2013.10.JNS131265
• Ranganathan S, Lee SH, Checkver A, et al. Magnetic resonance imaging finding of empty sella in obesity related idiopathic intracranial hypertension is associated with enlarged sella turcica. Neuroradiology. 2013;55(8):955-961. doi:10.1007/s00234-013-1207-0
• Yuh WT, Zhu M, Taoka T, et al. MR imaging of pituitary morphology in idiopathic intracranial hypertension. J Magn Reson Imaging. 2000;12(6): 808-813. doi:10.1002/1522-2586(200012)12:6<808::aid-jmri3>3.0.co;2-n
• Kesler A, Yaffe D, Shapira M, Kott E. Optic nerve sheath enlargement and reversal of optic nerve head in pseudotumor cerebri. Harefuah. 1996;130(7):457-503.
• Korkmazer B, Karaman AK, Kızılkılıç EK, et al. Efficacy of dural sinus quantitative measurements in idiopathic intracranial hypertension: a practical diagnostic feature. Clin Neuroradiol. 2023;33(2):545-554. doi: 10.1007/s00062-022-01244-0
• Beier D, Korsbæk JJ, Bsteh G, et al. Magnetic resonance imaging signs of idiopathic intracranial hypertension. JAMA Netw Open. 2024;7(7): e2420138. doi:10.1001/jamanetworkopen.2024.20138
• Weisberg LA. Computed tomography in benign intracranial hypertension. Neurology. 1985;35(7):1075-1078. doi:10.1212/wnl.35.7. 1075
• Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G. Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology. 2006;48(8):521-527. doi:10.1007/s00234-006-00 95-y
• Arkoudis NA, Davoutis E, Siderakis M, et al. Idiopathic intracranial hypertension: imaging and clinical fundamentals. World J Radiol. 2024; 16(12):722-748. doi:10.4329/wjr.v16.i12.722
• Zheng YM, Chen J, Yuan MG, Wu ZJ, Dong C. Does a change in ventricular size predict a diagnosis of cerebral venous thrombosis-related acute intracranial hypertension? Results of a retrospective imaging study. Acta Radiol. 2019;60(10):1308-1313. doi:10.1177/0284185118823346