Scheltens P, Pasquier F, Weerts J G, Barkhof F, Leys D
Department of Neurology, Academisch Ziekenhuis VU, Amsterdam, The Netherlands.
Eur Neurol. 1997;37(2):95-9. doi: 10.1159/000117417.
To assess the reproducibility of a qualitative rating scale of cerebral atrophy on MRI in an aged population of demented and non-demented individuals, 4 raters independently judged cerebral atrophy (CA) in 13 regions on a 0-3 scale on 75 MRI scans, on two occasions. The level of agreement was expressed by kappa statistics as well as by analysis of variance for interexaminer reproducibility studies. The mean CA scores ranged from 13.3 to 21.2, indicating moderately high prevalence of cerebral atrophy in this sample. Complete agreement among observers was reached in 49.7% of the ratings during the first assessment and in 44.1% in the second assessment. The inter-observer agreement was poor in both sessions (mean overall kappas 0.34 and 0.24). The intra-observer agreement was moderate to good for all raters (mean overall kappa: 0.58). The average standard deviation of the differences between CA scores of the 4 raters was 5.12 in the first and 5.13 in the second session. The average standard deviation for the differences within raters was 2.4. We conclude that the assessment of cerebral atrophy using this rating scale on MRI in an aged population has a poor reproducibility among raters. However, it provides regional atrophy measurements and is quite reliable when performed by a single rater.
为评估一种用于磁共振成像（MRI）的脑萎缩定性评分量表在老年痴呆和非痴呆人群中的可重复性，4名评估者在两次检查时，对75份MRI扫描图像上13个区域的脑萎缩情况，以0 - 3分进行独立评分。一致性水平通过kappa统计量以及评估者间可重复性研究的方差分析来表示。脑萎缩平均得分在13.3至21.2之间，表明该样本中脑萎缩患病率较高。第一次评估时，49.7%的评分中观察者间完全一致；第二次评估时，这一比例为44.1%。两次评估中观察者间一致性均较差（总体平均kappa值分别为0.34和0.24）。所有评估者的观察者内一致性为中等至良好（总体平均kappa值：0.58）。4名评估者脑萎缩评分差异的平均标准差在第一次评估时为5.12，第二次评估时为5.13。评估者内部差异的平均标准差为2.4。我们得出结论，在老年人群中使用该评分量表对MRI脑萎缩进行评估时，评估者间的可重复性较差。然而，它能提供区域萎缩测量结果，且由单一评估者进行时相当可靠。
