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Standardized image evaluation in patients with idiopathic normal pressure hydrocephalus: consistency and reproducibility.
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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, Observer variation, Tomography, x-ray computed
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-390960DOI: 10.1007/s00234-019-02273-2PubMedID: 31399851OAI: oai:DiVA.org:uu-390960DiVA, id: diva2:1343419
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-11-21

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