Department of Neurology, Charles University, Third Faculty of Medicine, Prague, Czech Republic.
Department of Anatomy, Charles University, Third Faculty of Medicine, Prague, Czech Republic.
Curr Alzheimer Res. 2020;17(6):534-539. doi: 10.2174/1567205017666200807193957.
The purpose of the study was to evaluate the reliability of our new visual scale for a quick atrophy assessment of parietal lobes on brain Magnetic Resonance Imaging (MRI) among different professionals. A good agreement would justify its use for differential diagnosis of neurodegenerative dementias, especially early-onset Alzheimer's Disease (AD), in clinical settings.
The visual scale named the Parietal Atrophy Score (PAS) is based on a semi-quantitative assessment ranging from 0 (no atrophy) to 2 (prominent atrophy) in three parietal structures (sulcus cingularis posterior, precuneus, parietal gyri) on T1-weighted MRI coronal slices through the whole parietal lobes. We used kappa statistics to evaluate intra-rater and inter-rater agreement among four raters who independently scored parietal atrophy using PAS. Rater 1 was a neuroanatomist (JM), rater 2 was an expert in MRI acquisition and analysis (II), rater 3 was a medical student (OP) and rater 4 was a neurologist (DS) who evaluated parietal atrophy twice in a 3-month interval to assess intra-rater agreement. All raters evaluated the same 50 parietal lobes on brain MRI of 25 cognitively normal individuals with even distribution across all atrophy degrees from none to prominent according to the neurologist's rating.
Intra-rater agreement was almost perfect with the kappa value of 0.90. Inter-rater agreement was moderate to substantial with kappa values ranging from 0.43-0.86.
The Parietal Atrophy Score is the reliable visual scale among raters of different professions for a quick evaluation of parietal lobes on brain MRI within 1-2 minutes. We believe it could be used as an adjunct measure in differential diagnosis of dementias, especially early-onset AD.
本研究旨在评估我们新的视觉量表在不同专业人员中对脑磁共振成像（MRI）上顶叶萎缩快速评估的可靠性。如果一致性良好，则可在临床环境中用于神经退行性痴呆，特别是早发性阿尔茨海默病（AD）的鉴别诊断。
该视觉量表命名为顶叶萎缩评分（PAS），基于 T1 加权 MRI 冠状切片穿过整个顶叶时三个顶叶结构（后扣带回沟、楔前叶、顶叶回）的半定量评估，范围从 0（无萎缩）到 2（明显萎缩）。我们使用 Kappa 统计评估了 4 名评分者使用 PAS 进行顶叶萎缩独立评分的内部和外部一致性。评分者 1 是神经解剖学家（JM），评分者 2 是 MRI 采集和分析专家（II），评分者 3 是医学生（OP），评分者 4 是神经科医生（DS），他们在 3 个月的间隔内两次评估顶叶萎缩以评估内部一致性。所有评分者都评估了 25 名认知正常个体的 50 个顶叶脑 MRI，根据神经科医生的评分，这些个体的顶叶萎缩程度均匀分布，从无到明显。
内部一致性几乎是完美的，kappa 值为 0.90。外部一致性为中度至高度一致，kappa 值范围为 0.43-0.86。
顶叶萎缩评分是不同专业评分者在 1-2 分钟内快速评估脑 MRI 上顶叶的可靠视觉量表。我们相信它可以作为鉴别诊断痴呆，特别是早发性 AD 的辅助措施。
