Inter- and intraobserver reproducibility of cerebral atrophy assessment on MRI scans with hemispheric infarcts
Inter- and intraobserver reproducibility of cerebral atrophy assessment on MRI scans with hemispheric infarcts
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DOI：
10.1159/000117270
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发表时间：
1996-09-01
影响因子：
2.4
通讯作者：
Scheltens, P
中科院分区：
文献类型：
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作者：
Pasquier, F;Leys, D;Scheltens, P
脑卒中患者的脑萎缩（CA）与脑卒中后痴呆有关，可能反映了潜在的神经退行性病理。因此，区域性CA可能对卒中后痴呆患者的研究有价值。本研究的目的是测试核磁共振上CA定性评定量表的可重复性。对50例连续入院的急性半球缺血性脑卒中患者（年龄范围19-81岁）进行MRI扫描。在轴向t2加权序列上，由4名独立观测者间隔24小时评估2次CA。我们对13个地区的CA进行了0-3级的评估。各分值之和称为CA分值（范围0-39）。一致性的水平是通过kappa统计和方差分析来表达的。CA的平均得分从2.8到11.0不等，表明该样本中CA的患病率较低。在第一次评估中有41.7%达到完全一致，在第二次评估中达到44.1%。观察者间的一致性在第一次会议中是中等的（平均总体kappa: 0.48），在第二次会议中是相当的（平均总体kappa: 0.67）。所有评分者的内部一致性都很好（平均kappa: 0.65）。标准化到量表范围后，4位评价者在2次会话中CA评分差异的标准差分别为11.1和11.2%；在评级机构内部，这一比例为4.4%。我们的结论是，使用该评定量表对卒中患者的CA进行评估是可行的。它提供了区域萎缩的测量，是可重复的，当执行1比率。
Cerebral atrophy (CA) in stroke patients is associated with poststroke dementia and may reflect underlying neurodegenerative pathology. Therefore, regional CA may be valuable to study in patients who develop poststroke dementia. The aim of this study was to test the reproducibility of a qualitative rating scale of CA on MRI. MRI scans were performed in 50 consecutive patients (age range 19-81) admitted for an acute hemispheric ischemic stroke. CA was assessed on 2 occasions 24 h apart, on axial T2-weighted sequences by 4 independent observers. We evaluated CA in 13 regions on a 0-3 scale. The sum of the subscores was called the CA score (range: 0-39). The level of agreement was expressed by kappa statistics as well as by analysis of variance for interexaminer reproducibility studies. The mean CA scores ranged from 2.8 to 11.0, indicating the low prevalence of CA in this sample. Complete agreement was reached in 41.7% during the first assessment and in 44.1% in the second assessment. The interobserver agreement was moderate in the first session (mean overall kappa: 0.48) and substantial in the second (mean overall kappa: 0.67). The intraobserver agreement was good for all raters (mean kappa: 0.65). Standardized to the range of the scale, standard deviations of the differences between CA scores of the 4 raters in the 2 sessions were 11.1 and 11.2%; within raters it was 4.4%. We conclude that the assessment of CA using this rating scale is possible in stroke patients. It provides regional atrophy measurements and is reproducible when performed by 1 rater.