Chacko Anith, Vedajallam Schadie, Andronikou Savvas, Simpson Ewan, Thai Ngoc Jade
CRICBristol, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom.
Department of Radiology Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America.
Indian J Radiol Imaging. 2020 Apr-Jun;30(2):111-115. doi: 10.4103/ijri.IJRI_130_20. Epub 2020 Jul 13.
Using text reports to communicate bilateral, symmetric, and zonal cortical brain atrophy in children with term hypoxic ischemic injury (HII) to parents and legal professionals contesting compensation rights can be difficult. Using standard cross-sectional images for explaining bilateral, regional brain imaging to laypeople is also challenging. A single flattened image of the brain surface, much like a map of the earth is derived from a globe, can be generated from curved reconstruction of magnetic resonance imaging (MRI) scans, i.e., a Mercator map. Laypeople's ability to identify abnormal "Mercator brain maps," without prior training, requires evaluation before use in nonmedical settings.
To determine the sensitivity and specificity of laypeople in detecting abnormal pediatric Mercator flat-earth maps of the brain, without prior training.
10 Mercator brain maps were provided to 111 participants individually. The maps comprised 5 HII, 1 cortical dysplasia, and 4 normal cases. Participants were required to identify the abnormal scans. Sensitivity and specificity overall and for participants' subgroups were calculated.
Overall sensitivity and specificity were 67% and 80%, respectively. General radiologists ( = 12) had sensitivity and specificity of 91.2% and 94.6%, respectively. Laypeople ( = 54) had a sensitivity of 67% and specificity of 80%.
The high specificity and sensitivity of radiologists validated the technique for distinguishing abnormal scans, regarding cortical pathology. High specificity of laypeople for identifying abnormal brains using Mercator maps indicates that this is a viable communication tool for demonstrating cortical MRI abnormalities of HII in children to laypersons.
对于患有足月缺氧缺血性损伤（HII）的儿童，使用文字报告向争夺赔偿权的家长和法律专业人士传达双侧、对称和区域性皮质脑萎缩情况可能存在困难。使用标准横断面图像向非专业人士解释双侧脑部成像也具有挑战性。通过磁共振成像（MRI）扫描的曲面重建可以生成大脑表面的单一扁平化图像，就像从地球仪得出的地球地图一样，即墨卡托地图。非专业人士在未经事先培训的情况下识别异常“墨卡托脑图”的能力，需要在用于非医疗环境之前进行评估。
确定非专业人士在未经事先培训的情况下检测儿童异常墨卡托扁平脑图的敏感性和特异性。
向111名参与者分别提供10张墨卡托脑图。这些脑图包括5例HII、1例皮质发育异常和4例正常病例。要求参与者识别异常扫描。计算总体以及参与者亚组的敏感性和特异性。
总体敏感性和特异性分别为67%和80%。普通放射科医生（n = 12）的敏感性和特异性分别为91.2%和94.6%。非专业人士（n = 54）的敏感性为67%，特异性为80%。
放射科医生的高特异性和敏感性验证了区分异常扫描的技术在皮质病理学方面的有效性。非专业人士使用墨卡托地图识别异常大脑的高特异性表明，这是一种向非专业人士展示儿童HII皮质MRI异常的可行沟通工具。
