Leonardi M, Ferro S, Agati R, Fiorani L, Righini A, Cristina E, D'Alessandro R
Neuroradiological Department, Udine Hospital, Italy.
Neuroradiology. 1994;36(1):17-9. doi: 10.1007/BF00599186.
To assess interobserver variability in estimation of brain atrophy based on CT, four neuroradiologists examined CT brain images of 150 consecutive patients without focal lesions. An independent neuroradiologist made the following quantitative measurements: frontal horn index, subarachnoid space area and the ratio between subarachnoid space area and inner skull space area. Level of agreement was fair for the presence (k = 0.24), slight for the degree (mild, moderate, severe) (k = 0.24) and moderate for the type (cortical, subcortical, mixed) of atrophy (k = 0.59). There was a highly significant correlation between the number of observers agreeing and quantitative measurements. We concluded that neuroradiologists' subjective estimation of brain atrophy alone is not reliable. Quantitative measurements would be needed in cases where the presence of brain atrophy might determine clinical decisions.
为评估基于CT对脑萎缩估计的观察者间变异性，四名神经放射科医生检查了150例无局灶性病变的连续患者的脑部CT图像。一名独立的神经放射科医生进行了以下定量测量：额角指数、蛛网膜下腔面积以及蛛网膜下腔面积与颅骨内空间面积的比值。对于萎缩的存在情况，一致性水平为中等（k = 0.24）；对于程度（轻度、中度、重度），一致性水平为轻微（k = 0.24）；对于萎缩类型（皮质型、皮质下型、混合型），一致性水平为中等（k = 0.59）。观察者达成一致的数量与定量测量之间存在高度显著的相关性。我们得出结论，仅靠神经放射科医生对脑萎缩的主观估计是不可靠的。在脑萎缩的存在可能决定临床决策的情况下，需要进行定量测量。
