Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 33, Seoul, 05505, Republic of Korea.
Eur Radiol. 2021 Jul;31(7):5300-5311. doi: 10.1007/s00330-020-07555-5. Epub 2021 Jan 6.
To evaluate the diagnostic performance and interobserver agreement of the callosal angle and Evans' index in idiopathic normal pressure hydrocephalus (iNPH).
A systematic search of MEDLINE and EMBASE was performed to find studies assessing the diagnostic performance or interobserver agreement of the callosal angle and Evans' index in iNPH. Pooled sensitivity and specificity of the two radiologic indices were calculated. The area under the curve (AUC) was obtained based on a hierarchical summary receiver operating characteristic curve. The diagnostic performances of both radiologic indices were compared in subgroup analysis. To evaluate interobserver agreement, the pooled correlation coefficient was calculated.
Ten original articles (874 patients) were included. The pooled sensitivity and specificity of the callosal angle in the diagnosis of iNPH were 91% (95% CI, 86-94%) and 93% (95% CI, 89-96%), respectively. The pooled sensitivity and specificity of Evans' index were 96% (95% CI, 47-100%) and 83% (95% CI, 77-88%), respectively. Subgroup analysis demonstrated a significant higher specificity of the callosal angle than that of Evans' index (p < 0.01). The AUC of the callosal angle and Evans' index were 0.97 (95% CI, 0.95-0.98) and 0.87 (95% CI, 0.84-0.90), respectively. The pooled correlation coefficients for the callosal angle and Evans' index were 0.92 (95% CI, 0.82-0.96) and 0.92 (95% CI, 0.83-0.97), respectively.
Our meta-analysis demonstrated a high performance of the callosal angle in the diagnosis of iNPH. Evans' index showed reasonable diagnostic performance with high sensitivity but low specificity. Interobserver agreements were excellent in both radiologic indices.
• Callosal angle showed high diagnostic performance in idiopathic normal pressure hydrocephalus. • Evans' index showed reasonable diagnostic performance with high sensitivity but low specificity. • Interobserver agreements were excellent in both callosal angle and Evans' index.
评估胼胝体角和 Evans 指数在特发性正常压力脑积水（iNPH）中的诊断性能和观察者间一致性。
系统检索 MEDLINE 和 EMBASE，以查找评估胼胝体角和 Evans 指数在 iNPH 中的诊断性能或观察者间一致性的研究。计算这两个影像学指标的合并敏感性和特异性。基于分层汇总受试者工作特征曲线获得曲线下面积（AUC）。在亚组分析中比较两种影像学指标的诊断性能。为了评估观察者间一致性，计算了合并相关系数。
纳入 10 项原始研究（874 例患者）。胼胝体角诊断 iNPH 的合并敏感性和特异性分别为 91%（95%CI，86-94%）和 93%（95%CI，89-96%）。Evans 指数的合并敏感性和特异性分别为 96%（95%CI，47-100%）和 83%（95%CI，77-88%）。亚组分析表明，胼胝体角的特异性显著高于 Evans 指数（p<0.01）。胼胝体角和 Evans 指数的 AUC 分别为 0.97（95%CI，0.95-0.98）和 0.87（95%CI，0.84-0.90）。胼胝体角和 Evans 指数的合并相关系数分别为 0.92（95%CI，0.82-0.96）和 0.92（95%CI，0.83-0.97）。
本荟萃分析表明胼胝体角在 iNPH 的诊断中具有较高的性能。Evans 指数具有较高的敏感性，但特异性较低，诊断性能合理。两种影像学指标的观察者间一致性均很好。
