Bruno Federico, Fagotti Cristina, Saltarelli Gaspare, Di Cerbo Giovanni, Sabatelli Alessandra, De Felici Claudia, Innocenzi Antonio, Di Cesare Ernesto, Splendiani Alessandra
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Neuroradiology, San Salvatore Hospital, 67100 L'Aquila, Italy.
Diagnostics (Basel). 2025 May 14;15(10):1246. doi: 10.3390/diagnostics15101246.
: Accurate assessment of brain atrophy is essential in the diagnosis and monitoring of brain aging and neurodegenerative disorders. Radiological methods range from narrative reporting to semi-quantitative visual rating scales (VRSs) and fully automated volumetric software. However, their integration and consistency in clinical practice remain limited. : In this retrospective study, brain MRI images of 43 patients were evaluated. Brain atrophy was assessed by extrapolating findings from narrative radiology reports, three validated VRSs (MTA, Koedam, Pasquier), and Pixyl.Neuro.BV, a commercially available volumetric software platform. Agreement between methods was assessed using intraclass correlation coefficients (ICCs), Cohen's kappa, Spearman's correlation, and McNemar tests. : Moderate correlation was found between narrative reports and VRSs (ρ = 0.55-0.69), but categorical agreement was limited (kappa = 0.21-0.30). Visual scales underestimated atrophy relative to software (mean scores: VRSs = 0.196; software = 0.279), while reports tended to overestimate. Agreement between VRSs and software was poor (kappa = 0.14-0.33), though MTA showed a significant correlation with hippocampal volume. Agreement between reports and software was lowest for global atrophy. : Narrative reports, while common in practice, show low consistency with structured scales and quantitative software, especially in subtle cases. VRSs improve standardization but remain subjective and less sensitive. Integrating structured scales and volumetric tools into clinical workflows may enhance diagnostic accuracy and consistency in dementia imaging.
准确评估脑萎缩对于脑老化和神经退行性疾病的诊断及监测至关重要。放射学方法涵盖从描述性报告到半定量视觉评级量表（VRSs）以及全自动容积软件。然而，它们在临床实践中的整合及一致性仍然有限。
在这项回顾性研究中，对43例患者的脑部MRI图像进行了评估。通过从描述性放射学报告、三种经过验证的VRSs（MTA、Koedam、Pasquier）以及Pixyl.Neuro.BV（一个商用容积软件平台）推断结果来评估脑萎缩。使用组内相关系数（ICCs）、科恩kappa系数、斯皮尔曼相关性以及麦克尼马尔检验来评估不同方法之间的一致性。
发现描述性报告与VRSs之间存在中等程度的相关性（ρ = 0.55 - 0.69），但分类一致性有限（kappa = 0.21 - 0.30）。相对于软件，视觉量表低估了萎缩情况（平均得分：VRSs = 0.196；软件 = 0.279），而报告往往高估。VRSs与软件之间的一致性较差（kappa = 0.14 - 0.33），不过MTA与海马体积显示出显著相关性。对于整体萎缩，报告与软件之间的一致性最低。
描述性报告虽然在实践中很常见，但与结构化量表和定量软件的一致性较低，尤其是在细微病例中。VRSs提高了标准化程度，但仍然主观且不太敏感。将结构化量表和容积工具整合到临床工作流程中可能会提高痴呆症成像的诊断准确性和一致性。
Zotero 插件