Quantitative approaches for assessment of white matter hyperintensities in elderly populations.
Quantitative approaches for assessment of white matter hyperintensities in elderly populations.
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DOI：
10.1016/j.pscychresns.2011.03.007
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发表时间：
2011-08-30
影响因子：
11.3
通讯作者：
Roose SP
中科院分区：
文献类型：
--
作者：
Brickman AM;Sneed JR;Provenzano FA;Garcon E;Johnert L;Muraskin J;Yeung LK;Zimmerman ME;Roose SP
白质高信号（WMH）是t2加权磁共振成像（MRI）上信号增加的区域，包括流体衰减逆恢复序列。在老年人中，总体和区域卫生产品负担（即数量或严重程度）与无数认知、神经和精神疾病有关。在当前的报告中，我们阐述了两种量化心室周围、深部和总WMH的方法，并在28名参加抑郁症治疗试验的老年患者中检验了它们的可靠性和标准效度。第一种方法是操作员驱动的定量方法，包括对单个MRI扫描进行目视检查，并使用三步程序进行手动标记。第二种方法是完全自动化的定量方法，使用涉及图像分割、体素强度阈值和种子生长的处理流来标记WMH并自动计算它们的体积。两种方法的WMH定量结果一致（Cronbach’s alpha值为0.835 ~ 0.968）。此外，WMH的严重程度与抑郁加重和年龄增加显著相关，这些关联在两种量化方法之间没有显著差异。我们为两种方法提供了良好的信度和标准效度的证据。操作者驱动的方法可能更适合由训练有素的评分员进行的小型研究，而全自动定量方法可能更适合于大型、高通量的研究。
White matter hyperintensities (WMH) are areas of increased signal on T2-weighted magnetic resonance imaging (MRI), including fluid attenuated inverse recovery sequences. Total and regional WMH burden (i.e., volume or severity) has been associated with myriad cognitive, neurological, and psychiatric conditions among older adults. In the current report, we illustrate two approaches to quantify periventricular, deep, and total WMH and examine their reliability and criterion validity among 28 elderly patients enrolled in a depression treatment trial. The first approach, an operator-driven quantitative approach, involves visual inspection of individual MRI scans and manual labeling using a three-step series of procedures. The second approach, a fully automated quantitative approach, uses a processing stream that involves image segmentation, voxel intensity thresholding, and seed growing to label WMH and calculate their volume automatically. There was good agreement in WMH quantification between the two approaches (Cronbach’s alpha values from 0.835 to 0.968). Further, severity of WMH was significantly associated with worse depression and increased age, and these associations did not differ significantly between the two quantification approaches. We provide evidence for good reliability and criterion validity for two approaches for WMH volume determination. The operator-driven approach may be better suited for smaller studies with highly trained raters, whereas the fully automated quantitative approach may be more appropriate for larger, high-throughput studies.