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Standardized image evaluation in patients with idiopathic normal pressure hydrocephalus: consistency and reproducibility
Umea Univ, Dept Pharmacol & Clin Neurosci Neurol Ostersund, SE-90187 Umea, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Landtblom: Neurology.
Umea Univ, Dept Radiat Sci Diagnost Radiol, SE-90187 Umea, Sweden.
Ostersund Hosp, Unit Res Educ & Dev, SE-83131 Ostersund, Sweden.
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2019 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 61, no 12, p. 1397-1406Article in journal (Refereed) Published
Abstract [en]

Purpose

Assess the agreement for two investigators between computed tomography (CT) and magnetic resonance imaging (MRI) for seven imaging features included in the iNPH Radscale, a radiological screening tool.

Methods

The study included 35 patients with idiopathic normal pressure hydrocephalus (iNPH) who were treated surgically from 2011 to 2015 at Uppsala University Hospital with preoperative CT and MRI performed with maximum 3 months between scans. Seven features were assessed: Evans’ index, temporal horn size, callosal angle, periventricular white matter changes, narrow high convexity sulci, focally enlarged sulci, and enlarged Sylvian fissures. All scans were assessed by two investigators who were blinded to each other’s results and to clinical data.

Results

The agreement between CT and MRI was almost perfect for Evans’ index, temporal horns, narrow sulci, and Sylvian fissures (kappa and intraclass correlation, 0.84–0.91, p ≤ 0.001). There was substantial to almost perfect agreement for callosal angle and focally enlarged sulci. The concordance between modalities was fair for changes in periventricular white matter.

Conclusion

CT and MRI are equally good for assessing radiological signs associated with iNPH except for periventricular white matter changes, as MRI has superior soft tissue contrast. The other imaging features can be evaluated consistently, and assessments are reproducible independent of modality. Therefore, the iNPH Radscale is applicable to both CT and MRI and may become an important tool for standardized evaluation in the workup in patients with suspected iNPH.

Place, publisher, year, edition, pages
2019. Vol. 61, no 12, p. 1397-1406
Keywords [en]
Hydrocephalus, normal pressure, Magnetic resonance imaging, Tomography, x-ray computed, Observer variation
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:uu:diva-398296DOI: 10.1007/s00234-019-02273-2ISI: 000495810200006PubMedID: 31399851OAI: oai:DiVA.org:uu-398296DiVA, id: diva2:1375296
Available from: 2019-12-04 Created: 2019-12-04 Last updated: 2020-04-24Bibliographically approved

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Virhammar, JohanLarsson, Elna-MarieLaurell, Katarina

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