A new rating scale for age-related white matter changes applicable to MRI and CT
A new rating scale for age-related white matter changes applicable to MRI and CT
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DOI：
10.1161/01.str.32.6.1318
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发表时间：
2001-06-01
期刊：
影响因子：
8.3
通讯作者：
Scheltens, P
中科院分区：
文献类型：
--
作者：
Wahlund, LO;Barkhof, F;Scheltens, P
背景与目的—MRI在检测年龄相关性白质变化（age-related white matter changes， ARWMC）方面比CT更敏感，大多数分级量表对ARWMC的程度和分布进行评估，要么在CT上，要么在MRI上，两者在许多方面存在差异。这使得比较CT和MRI研究变得困难。为了能够在大样本患者中研究药物治疗对ARWMC的演变和可能的影响，有必要构建一个MRI和CT的评分量表。我们开发并评估了一种新的量表，并在大量MRI和CT检查的患者中研究了ARWMC。方法：招募了77例CT或MRI显示为ARWMC的患者，并进行了MRI或CT的补充检查。患者来自欧洲的4个中心，扫描由4位评分者用新的ARWMC评分量表进行评分。采用K统计量评价互译器的信度。比较不同脑区ARWMC在CT和MRI扫描上的程度和分布。结果- MRI的评分信度较好（kappa =0.67）， CT的评分信度中等（kappa =0.48）。MRI对小的ARWMC的检测效果较好，而CT和MRI对较大病变的检测效果同样好，在顶枕和幕下病变中，MRI检测到的ARWMC明显多于CT。在额叶区和基底神经节，不同的治疗方式没有发现差异。当使用液体衰减反转恢复序列时，MRI在额部和顶枕区检测到的病变明显多于CT。基底节区和幕下区无差异。结论：我们提出了一种新的ARWMC量表，适用于CT和MRI，除了某些区域外，灵敏度几乎相同。MRI的互译可靠性稍好，小病变的可检出性也稍好。
Background and Purpose - MRI is more sensitive than CT for detection of age-related white matter changes (ARWMC), Most rating scales estimate the degree and distribution of ARWMC either on CT or on MRI, and they differ in many aspects. This makes it difficult to compare CT and MRI studies. To be able to study the evolution and possible effect of drug treatment on ARWMC in large patient samples, it is necessary to have a rating scale constructed for both MRI and CT. We have developed and evaluated a new scale and studied ARWMC in a large number of patients examined with both MRI and CT.Methods - Seventy-seven patients with ARWMC on either CT or MRI were recruited and a complementary examination (MRI or CT) performed. The patients came from 4 centers in Europe, and the scans were rated by 4 raters on I occasion with the new ARWMC rating scale. The interrater reliability was evaluated by using K statistics. The degree and distribution of ARWMC in CT and MRI scans were compared in different brain areas.Results - Interrater reliability was good for MRI (kappa =0.67) and moderate for CT (kappa =0.48). MRI was superior in detection of small ARWMC, whereas larger lesions were detected equally well with both CT and MRI, In the parieto-occipital and infratentorial ai-eas, MRI detected significantly more ARWMC than did CT. In the frontal area and basal ganglia, no differences between modalities were found. When a fluid-attenuated inversion recovery sequence was used, MRI detected significantly more lesions than CT in frontal and parieto-occipital areas. No differences were found in basal ganglia and infratentorial areas.Conclusions - We present a new ARWMC scale applicable to both CT and MRI that has almost equal sensitivity, except for certain regions. The interrater reliability was slightly better for MRI, as was the detectability of small lesions.