Dataset Information

Usefulness of B-scan ocular ultrasound images for diagnosis of optic perineuritis.

ABSTRACT:

Purpose

This study was performed to examine the usefulness of B-scan ocular ultrasound images for the diagnosis of optic perineuritis.

Observations

A 72-year-old woman developed nonpainful blurred vision in her left eye. At the first ophthalmological consultation, she had optic disc swelling and choroidal folds in both eyes and subretinal fluid in the left eye. She was referred to our clinic 1 month after symptom onset. At the first visit to our clinic, she still complained of blurred vision. She was found to have mild vitreous cells in the left eye and optic disc swelling in both eyes. However, the choroidal folds had already resolved in both eyes. B-scan ultrasound images displayed the optic nerve sheath as a highly reflective circle with shadowing around the optic disc in both eyes and scleral thickening in the left eye with fluid in sub-Tenon's space. Bilateral optic perineuritis with posterior scleritis seemed highly plausible. Magnetic resonance imaging with intravenous contrast revealed increased signal intensity around the optic nerve (i.e., the "tram track sign") in both eyes, which was consistent with optic perineuritis.

Conclusion and importance

Optic perineuritis is a rare inflammatory disorder involving the optic nerve sheath. Although magnetic resonance imaging is reportedly useful for diagnosis of this disease, no previous reports have described B-scan ultrasound imaging for this purpose. We herein provide the first report of a patient suspected to have optic perineuritis based on B-scan images. B-scan ultrasound may be useful for diagnosis of optic perineuritis, especially with inflammation surrounding the optic nerve.

SUBMITTER: Edo A

PROVIDER: S-EPMC6120595 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

Usefulness of B-scan ocular ultrasound images for diagnosis of optic perineuritis.

Edo Ayaka A Harada Yosuke Y Kiuchi Yoshiaki Y

American journal of ophthalmology case reports 20180829

<h4>Purpose</h4>This study was performed to examine the usefulness of B-scan ocular ultrasound images for the diagnosis of optic perineuritis.<h4>Observations</h4>A 72-year-old woman developed nonpainful blurred vision in her left eye. At the first ophthalmological consultation, she had optic disc swelling and choroidal folds in both eyes and subretinal fluid in the left eye. She was referred to our clinic 1 month after symptom onset. At the first visit to our clinic, she still complained of blu ...[more]

PMID: 30182069

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Project description:BackgroundAccurate diagnosis of unexplained cervical lymphadenopathy (CLA) using medical images heavily relies on the experience of radiologists, which is even worse for CLA patients in underdeveloped countries and regions, because of lack of expertise and reliable medical history. This study aimed to develop a deep learning (DL) radiomics model based on B-mode and color Doppler ultrasound images for assisting radiologists to improve their diagnoses of the etiology of unexplained CLA.MethodsPatients with unexplained CLA who received ultrasound examinations from three hospitals located in underdeveloped areas of China were retrospectively enrolled. They were all pathologically confirmed with reactive hyperplasia, tuberculous lymphadenitis, lymphoma, or metastatic carcinoma. By mimicking the diagnosis logic of radiologists, three DL sub-models were developed to achieve the primary diagnosis of benign and malignant, the secondary diagnosis of reactive hyperplasia and tuberculous lymphadenitis in benign candidates, and of lymphoma and metastatic carcinoma in malignant candidates, respectively. Then, a CLA hierarchical diagnostic model (CLA-HDM) integrating all sub-models was proposed to classify the specific etiology of each unexplained CLA. The assistant effectiveness of CLA-HDM was assessed by comparing six radiologists between without and with using the DL-based classification and heatmap guidance.ResultsA total of 763 patients with unexplained CLA were enrolled and were split into the training cohort (n=395), internal testing cohort (n=171), and external testing cohorts 1 (n=105) and 2 (n=92). The CLA-HDM for diagnosing four common etiologies of unexplained CLA achieved AUCs of 0.873 (95% CI: 0.838-0.908), 0.837 (95% CI: 0.789-0.889), and 0.840 (95% CI: 0.789-0.898) in the three testing cohorts, respectively, which was systematically more accurate than all the participating radiologists. With its assistance, the accuracy, sensitivity, and specificity of six radiologists with different levels of experience were generally improved, reducing the false-negative rate of 2.2-10% and the false-positive rate of 0.7-3.1%.ConclusionsMulti-cohort testing demonstrated our DL model integrating dual-modality ultrasound images achieved accurate diagnosis of unexplained CLA. With its assistance, the gap between radiologists with different levels of experience was narrowed, which is potentially of great significance for benefiting CLA patients in underdeveloped countries and regions worldwide.

Dataset Information

Usefulness of B-scan ocular ultrasound images for diagnosis of optic perineuritis.

Purpose

Observations

Conclusion and importance

Publications

Usefulness of B-scan ocular ultrasound images for diagnosis of optic perineuritis.

Similar Datasets

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