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Neuroradiology

, Volume 36, Issue 1, pp 17–19 | Cite as

Interobserver variability in CT assessment of brain atrophy

  • M. Leonardi
  • S. Ferro
  • R. Agati
  • L. Fiorani
  • A. Righini
  • E. Cristina
  • R. D'Alessandro
Diagnostic Neuroradiology

Abstract

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.

Key words

Brain atrophy Interobserver variability Computed tomography 

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References

  1. 1.
    Moseley I (1986) Diagnostic imaging in neurological disease. Churchill Livingstone, EdinburghGoogle Scholar
  2. 2.
    LeMay M (1984) Radiologic changes of the aging brain and skull. AJNR 5:269–275Google Scholar
  3. 3.
    Leonardi M, Martelli A, Costa A, Mauri M, Zanotti B, Zappoli F (1991) Imageric cérébrale: applications neuropathologiques à la maladie d'Alzheimer: le rôle de la TDM et evaluation endocrine. Bull Assoc Anat 75:97–99Google Scholar
  4. 4.
    Kohlmeyer K, Shamena AR (1983) CT assessment of CSF spaces in the brain in demented and nondemented patients over 60 years of age. AJNR 4:706–707Google Scholar
  5. 5.
    Laffey PA, Peyster RG, Nathan R, Haskin ME, McGinley JA (1984) Computed tomography and aging: results in a normal elderly population. Neuroradiology 26:273–278Google Scholar
  6. 6.
    LeMay M (1986) CT changes in dementing diseases: a review. AJNR 147:963–975Google Scholar
  7. 7.
    Nagata K, Basugi N, Fukushima T, et al (1987) A quantitative study of physiological cerebral atrophy with aging. A statistical analysis of the normal range. Neuroradiology 29:327–332Google Scholar
  8. 8.
    Gomori JM, Steiner I, Melamed E, Cooper G (1984) The assessment of changes in brain volume using combined linear measurements. A CT-scan study. Neuroradiology 26:21–24Google Scholar
  9. 9.
    Sabattini L (1982) Evaluation and measurement of the normal ventricular and subarachnoid spaces by CT. Neuroradiology 23: 1–5Google Scholar
  10. 10.
    Hirashima Y, Shindo K, Endo S (1987) Measurement of the area of the anterior horn of the right lateral ventricle for the diagnosis of brain atrophy by CT. Neuroradiology 25:23–27Google Scholar
  11. 11.
    Adam P, Fabre N, Guell A, Bessoles G, Roulleau J, Bès A (1983) Cortical atrophy in Parkinson disease: correlation between clinical and CT findings with special emphasis on prefrontal atrophy. AJNR 4:442–445Google Scholar
  12. 12.
    Yerby MS, Sudsten JW, Larson EB, Wu SA, Sumi SM (1985) A new method of measuring brain atrophy: the effect of aging in its application for diagnosing dementia. Neurology 35:1316–1320Google Scholar
  13. 13.
    Steiner I, Gomori JM, Melamed E (1985) Features of brain atrophy in Parkinson's disease. ACT scan study. Neuroradiology 27:158–160Google Scholar
  14. 14.
    Lee D, Fox A, Viñuela F, et al (1987) Interobserver variation in computed tomography of the brain. Arch Neurol 44:30–31Google Scholar
  15. 15.
    Soininen H, Puranen M, Riekkinen PJ (1982) Computed tomography findings in senile dementia and normal ageing. J Neurol Neurosurg Psychiatry 45:50–54Google Scholar
  16. 16.
    LeMay M, Stafford JL, Sandor T, Albert M, Haykal H, Zamani A (1986) Statistical assessment of percentual CT scan ratings in patients with Alzheimer type dementia. J Comput Assist Tomogr 10:802–809Google Scholar
  17. 17.
    Inzelberg R, Treves T, Reider I, Gerlenter I, Korczyn AD (1987) Computed tomography brain changes in Parkinsonian dementia. Neuroradiology 29:535–539Google Scholar
  18. 18.
    De Leon MJ (1989) Alzheimer's Disease: longitudinal CT studies of ventricular change. AJNR 10:371–376Google Scholar
  19. 19.
    Arai H, Kobayasci K, Ikeda K, Nagao Y, Ogiara R, Kosaka K (1983) A computed tomography study of Alzheimer's disease. J Neurol 229:69–77Google Scholar
  20. 20.
    Agati R, D'Alessandro R, Fiorani L, Righini A, Leonardi M (1992) Valutazione quantitative dell'atrofia cerebrale in tomografia computerizzata. Rivis Neuroradiol 5:185–193Google Scholar
  21. 21.
    Fleiss JH (1971) Measuring nominal scale agreement among many raters. Psychol Bull 76:378–382Google Scholar
  22. 22.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174Google Scholar
  23. 23.
    Fleiss JL (1981) Statistical methods for rates and proportion. Wiley, Louton, pp 212–234Google Scholar
  24. 24.
    Von Gall M, Artmann H, Lerch G, Nemeth N (1978) Results of computed tomography on chronic alcoholics. Neuroradiology 16:329–331Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • M. Leonardi
    • 1
  • S. Ferro
    • 2
  • R. Agati
    • 3
  • L. Fiorani
    • 2
  • A. Righini
    • 3
  • E. Cristina
    • 2
  • R. D'Alessandro
    • 2
  1. 1.Neuroradiological DepartmentUdine HospitalUdineItaly
  2. 2.Institute of Neurology, Neuroepidemiology UnitUniversity of BolognaBolognaItaly
  3. 3.Neuroradiological UnitUniversity of BolognaBolognaItaly

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