van Swieten J C, Hijdra A, Koudstaal P J, van Gijn J
Department of Neurology, University Hospital, Utrecht, The Netherlands.
J Neurol Neurosurg Psychiatry. 1990 Dec;53(12):1080-3. doi: 10.1136/jnnp.53.12.1080.
We developed and tested a simple three-point scale for grading white matter lesions in anterior and posterior regions of the brain. Twenty four CT scans and 24 MRI scans were separately judged by 11 and five observers, respectively, on the presence and severity of white matter lesions. The observers were radiologists and neurologists. For CT scans, these periventricular changes were graded according to their extent as absent, or partly involving the white matter, or extending up to the subcortical region. The MRI lesions were graded as no lesion or only a single one, multiple focal lesions, and multiple confluent lesions. The pairwise agreements of all possible combinations of observers for each scan were corrected for chance (kappa statistics; maximal agreement 1.0). The weighted kappa value, for anterior and posterior regions combined, was 0.63 for CT scans, and 0.78 for MRI scans. This three-point scale for two separate regions seems suitable as a basis for cross-sectional or longitudinal studies of large series of patients.
我们开发并测试了一种简单的三点量表，用于对大脑前后区域的白质病变进行分级。分别由11名观察者对24份CT扫描和5名观察者对24份MRI扫描的白质病变的存在情况和严重程度进行判断。观察者为放射科医生和神经科医生。对于CT扫描，根据脑室周围变化的范围将其分级为不存在、部分累及白质或延伸至皮质下区域。MRI病变被分级为无病变或仅有单个病变、多个局灶性病变以及多个融合性病变。对每次扫描的观察者所有可能组合的两两一致性进行了机遇校正（kappa统计量；最大一致性为1.0）。对于CT扫描，大脑前后区域合并后的加权kappa值为0.63，对于MRI扫描为0.78。这种针对两个不同区域的三点量表似乎适合作为对大量患者进行横断面或纵向研究的基础。
