From the Epilepsy Center (S.L., M.M.-S., S.J., D.V., W.B., L.J.), and.
Institute of Neuropathology (I.B.), University Hospitals Erlangen, Erlangen, Germany.
AJNR Am J Neuroradiol. 2020 Apr;41(4):591-597. doi: 10.3174/ajnr.A6454. Epub 2020 Mar 26.
NeuroQuant is an FDA-approved software that performs automated MR imaging quantitative volumetric analysis. This study aimed to compare the accuracy of NeuroQuant analysis with visual MR imaging analysis by neuroradiologists with expertise in epilepsy in identifying hippocampal sclerosis.
We reviewed 144 adult patients who underwent presurgical evaluation for temporal lobe epilepsy. The reference standard for hippocampal sclerosis was defined by having hippocampal sclerosis on pathology ( = 61) or not having hippocampal sclerosis on pathology ( = 83). Sensitivities, specificities, positive predictive values, and negative predictive values were compared between NeuroQuant analysis and visual MR imaging analysis by using a McNemar paired test of proportions and the Bayes theorem.
NeuroQuant analysis had a similar specificity to neuroradiologist visual MR imaging analysis (90.4% versus 91.6%; = .99) but a lower sensitivity (69.0% versus 93.0%, < .001). The positive predictive value of NeuroQuant analysis was comparable with visual MR imaging analysis (84.0% versus 89.1%), whereas the negative predictive value was not comparable (79.8% versus 95.0%).
Visual MR imaging analysis by a neuroradiologist with expertise in epilepsy had a higher sensitivity than did NeuroQuant analysis, likely due to the inability of NeuroQuant to evaluate changes in hippocampal T2 signal or architecture. Given that there was no significant difference in specificity between NeuroQuant analysis and visual MR imaging analysis, NeuroQuant can be a valuable tool when the results are positive, particularly in centers that lack neuroradiologists with expertise in epilepsy, to help identify and refer candidates for temporal lobe epilepsy resection. In contrast, a negative test could justify a case referral for further evaluation to ensure that false-negatives are detected.
NeuroQuant 是一款获得 FDA 批准的软件，可进行自动磁共振成像定量容积分析。本研究旨在比较神经定量分析与具有癫痫专长的神经放射科医师的视觉磁共振成像分析在识别海马硬化方面的准确性。
我们回顾了 144 例接受颞叶癫痫术前评估的成年患者。海马硬化的参考标准定义为病理学上存在海马硬化（=61 例）或病理学上不存在海马硬化（=83 例）。使用 McNemar 配对比例检验和贝叶斯定理比较神经定量分析与视觉磁共振成像分析的敏感性、特异性、阳性预测值和阴性预测值。
神经定量分析的特异性与神经放射科医师的视觉磁共振成像分析相似（90.4%对 91.6%；=0.99），但敏感性较低（69.0%对 93.0%，<.001）。神经定量分析的阳性预测值与视觉磁共振成像分析相当（84.0%对 89.1%），而阴性预测值则不可比（79.8%对 95.0%）。
具有癫痫专长的神经放射科医师的视觉磁共振成像分析敏感性高于神经定量分析，可能是因为神经定量无法评估海马 T2 信号或结构的变化。鉴于神经定量分析与视觉磁共振成像分析的特异性之间没有显著差异，当结果为阳性时，神经定量分析可以成为一种有价值的工具，特别是在缺乏具有癫痫专长的神经放射科医师的中心，可以帮助识别和推荐颞叶癫痫切除术的候选人。相比之下，阴性测试可以证明需要进一步评估以确保检测到假阴性。
