Azab M, Carone M, Ying S H, Yousem D M
From the Division of Neuroradiology (M.A., S.H.Y., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland Department of Radiology (M.A.), Suez Canal University, Ismaïlia, Ismailia Governorate.
Department of Biostatistics (M.C.), University of Washington, Seattle, Washington.
AJNR Am J Neuroradiol. 2015 Aug;36(8):1400-6. doi: 10.3174/ajnr.A4313. Epub 2015 Apr 23.
We sought to compare the accuracy of a volumetric fully automated computer assessment of hippocampal volume asymmetry versus neuroradiologists' interpretations of the temporal lobes for mesial temporal sclerosis. Detecting mesial temporal sclerosis (MTS) is important for the evaluation of patients with temporal lobe epilepsy as it often guides surgical intervention. One feature of MTS is hippocampal volume loss.
Electronic medical record and researcher reports of scans of patients with proved mesial temporal sclerosis were compared with volumetric assessment with an FDA-approved software package, NeuroQuant, for detection of mesial temporal sclerosis in 63 patients. The degree of volumetric asymmetry was analyzed to determine the neuroradiologists' threshold for detecting right-left asymmetry in temporal lobe volumes.
Thirty-six patients had left-lateralized MTS, 25 had right-lateralized MTS, and 2 had bilateral MTS. The estimated accuracy of the neuroradiologist was 72.6% with a κ statistic of 0.512 (95% CI, 0.315-0.710) [moderate agreement, P < 3 × 10(-6)]), whereas the estimated accuracy of NeuroQuant was 79.4% with a κ statistic of 0.588 (95% CI, 0.388-0.787) [moderate agreement, P < 2 × 10(-6)]). This discrepancy in accuracy was not statistically significant. When at least a 5%-10% volume discrepancy between temporal lobes was present, the neuroradiologists detected it 75%-80% of the time.
As a stand-alone fully automated software program that can process temporal lobe volume in 5-10 minutes, NeuroQuant compares favorably with trained neuroradiologists in predicting the side of mesial temporal sclerosis. Neuroradiologists can often detect even small temporal lobe volumetric changes visually.
我们试图比较海马体积不对称的体积完全自动化计算机评估与神经放射科医生对颞叶内侧颞叶硬化的解读的准确性。检测内侧颞叶硬化(MTS)对于颞叶癫痫患者的评估很重要,因为它通常指导手术干预。MTS的一个特征是海马体积缩小。
将经证实患有内侧颞叶硬化患者的电子病历和研究人员的扫描报告与使用FDA批准的软件包NeuroQuant进行的体积评估进行比较,以检测63例患者的内侧颞叶硬化。分析体积不对称程度以确定神经放射科医生检测颞叶体积左右不对称的阈值。
36例患者为左侧MTS,25例为右侧MTS,2例为双侧MTS。神经放射科医生的估计准确率为72.6%,κ统计量为0.512(95%CI,0.315 - 0.710)[中度一致性,P < 3×10(-6)],而NeuroQuant的估计准确率为79.4%,κ统计量为0.588(95%CI,0.388 - 0.787)[中度一致性,P < 2×10(-6)]。这种准确性差异无统计学意义。当颞叶之间至少存在5%-10%的体积差异时,神经放射科医生在75%-80%的时间内能够检测到。
作为一个可在5-10分钟内处理颞叶体积的独立完全自动化软件程序,NeuroQuant在预测内侧颞叶硬化的侧别方面与训练有素的神经放射科医生相比具有优势。神经放射科医生通常能够通过视觉检测到即使是很小的颞叶体积变化。