| Defining optic nerve tortuosity. | |
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MedLine Citation:
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PMID: 17416818 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Optic nerve tortuosity is one of several nonmalignant abnormalities documented on MR imaging in patients with neurofibromatosis type 1 and may be related to the development of optic pathway gliomas. This study seeks an operational definition for optic nerve tortuosity. MATERIALS AND METHODS: A focus group of 3 pediatric neuroradiologists reviewed 20 MR images of the brain and orbits of patients suspected to have optic nerve tortuosity in the absence of optic pathway glioma and found 6 radiographic factors that occurred frequently. Subsequently, 28 MR images were assessed for the presence of optic nerve tortuosity, using a global assessment question that reflects a neuroradiologist's confidence in the presence of optic nerve tortuosity, and for the presence of the 6 radiographic factors, to identify a combination of these factors that best predicted a diagnosis of optic nerve tortuosity. RESULTS: We found perfect inter-rater agreement between 3 readers on the presence/absence of tortuosity in 75% of cases. Lack of congruity of the optic nerves, in more than 1 coronal section and dilation of the subarachnoid space surrounding the optic nerves, when found together are sensitive (89%) and specific (93%) for a diagnosis of tortuosity on the global scale. The absence of these 2 factors, along with absence of deviation of the optic nerve within the axial plane, provides a reliable test to exclude tortuosity. CONCLUSION: Lack of congruity of the optic nerves in more than 1 coronal section and dilation of the subarachnoid space surrounding the optic nerves together provide an operational radiographic definition of optic nerve tortuosity. |
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Authors:
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G T Armstrong; A R Localio; T Feygin; L Bilaniuk; P C Phillips; M J Fisher; B L Strom; R Zimmerman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: 28 ISSN: 0195-6108 ISO Abbreviation: AJNR Am J Neuroradiol Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-09 Completed Date: 2007-06-07 Revised Date: 2008-02-14 |
Medline Journal Info:
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Nlm Unique ID: 8003708 Medline TA: AJNR Am J Neuroradiol Country: United States |
Other Details:
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Languages: eng Pagination: 666-71 Citation Subset: IM |
Affiliation:
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Division of Oncology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine Philadelphia, PA, USA. greg.armstrong@stjude.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Brain Humans Magnetic Resonance Imaging* Models, Statistical Neurofibromatosis 1 / complications, pathology Observer Variation Optic Nerve / abnormalities* Optic Nerve Glioma / complications, pathology Orbit / pathology |
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