MRI markers of idiopathic normal pressure hydrocephalus in a population study with 791 participants: Exploring reference values and associations.

IF 1.3 Q4 NEUROIMAGING Neuroradiology Journal Pub Date : 2024-12-09 DOI:10.1177/19714009241303132

Clara Constantinescu, Doerthe Ziegelitz, Carsten Wikkelsø, Silke Kern, Daniel Jaraj, Lina Rydén, Eric Westman, Ingmar Skoog, Mats Tullberg

{"title":"MRI markers of idiopathic normal pressure hydrocephalus in a population study with 791 participants: Exploring reference values and associations.","authors":"Clara Constantinescu, Doerthe Ziegelitz, Carsten Wikkelsø, Silke Kern, Daniel Jaraj, Lina Rydén, Eric Westman, Ingmar Skoog, Mats Tullberg","doi":"10.1177/19714009241303132","DOIUrl":null,"url":null,"abstract":"Purpose: Epidemiological studies on idiopathic normal pressure hydrocephalus (iNPH) imaging markers and their normal values are scarce. This population-based study aimed to analyze several morphologic and volumetric iNPH-related imaging markers in a large sample, determining their distribution, diagnostic accuracy, suggested cut-offs, and associations with iNPH symptoms.Methods: This cross-sectional study included 791 70 year olds, 40 with radiologically probable iNPH (iNPHRadiol) and 751 without iNPH features (reference). MRI measures included Evans index (EI), z-EI, brain per ventricle ratio at anterior (BVRAC) and posterior commissures (BVRPC), sulcal compression, Sylvian fissure enlargement, callosal angle, diameter of temporal horns, 3rd and 4th ventricles, midbrain, and pons. Volumes of ventricles, corpus callosum, and brainstem were computed using automated segmentation. ROC analysis determined imaging markers' cut-offs. Symptoms were evaluated clinically and through self-report.Results: In the reference group, median values (95% CI) for imaging markers were as follows: EI: 0.27 (0.26-0.27), z-EI: 0.28 (0.26-0.31), BVRAC: 1.69 (1.48-1.90), and BVRPC: 2.66 (2.24-3.27). Most imaging markers differed significantly between iNPHRadiol and the reference. Lateral ventricle volumes correlated better with z-EI and BVR than EI (Rs > 0.81 vs 0.68). Optimal cut-off values for z-EI, and BVRAC and BVRPC for distinguishing iNPHRadiol were 0.32, 1.36, and 1.83, respectively. Clinical symptoms correlated moderately with imaging markers (Rs < 0.49 for iNPHRadiol, p < .01).Conclusions: We report population-based reference values and propose cut-offs for iNPH-related imaging markers and volumetric measurements. Z-EI and BVR are likely superior markers for assessing ventricular enlargement in iNPH. Imaging markers of iNPH correlate moderately with iNPH symptoms.","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303132"},"PeriodicalIF":1.3000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626555/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19714009241303132","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NEUROIMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Epidemiological studies on idiopathic normal pressure hydrocephalus (iNPH) imaging markers and their normal values are scarce. This population-based study aimed to analyze several morphologic and volumetric iNPH-related imaging markers in a large sample, determining their distribution, diagnostic accuracy, suggested cut-offs, and associations with iNPH symptoms.

Methods: This cross-sectional study included 791 70 year olds, 40 with radiologically probable iNPH (iNPH_Radiol) and 751 without iNPH features (reference). MRI measures included Evans index (EI), z-EI, brain per ventricle ratio at anterior (BVR_AC) and posterior commissures (BVR_PC), sulcal compression, Sylvian fissure enlargement, callosal angle, diameter of temporal horns, 3^rd and 4^th ventricles, midbrain, and pons. Volumes of ventricles, corpus callosum, and brainstem were computed using automated segmentation. ROC analysis determined imaging markers' cut-offs. Symptoms were evaluated clinically and through self-report.

Results: In the reference group, median values (95% CI) for imaging markers were as follows: EI: 0.27 (0.26-0.27), z-EI: 0.28 (0.26-0.31), BVR_AC: 1.69 (1.48-1.90), and BVR_PC: 2.66 (2.24-3.27). Most imaging markers differed significantly between iNPH_Radiol and the reference. Lateral ventricle volumes correlated better with z-EI and BVR than EI (Rs > 0.81 vs 0.68). Optimal cut-off values for z-EI, and BVR_AC and BVR_PC for distinguishing iNPH_Radiol were 0.32, 1.36, and 1.83, respectively. Clinical symptoms correlated moderately with imaging markers (Rs < 0.49 for iNPH_Radiol, p < .01).

Conclusions: We report population-based reference values and propose cut-offs for iNPH-related imaging markers and volumetric measurements. Z-EI and BVR are likely superior markers for assessing ventricular enlargement in iNPH. Imaging markers of iNPH correlate moderately with iNPH symptoms.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

在一项包含 791 名参与者的人群研究中，特发性正常压力脑积水的 MRI 标记：探索参考值和关联。

目的：特发性正常压力脑积水（iNPH）影像学指标及其正常值的流行病学研究很少。这项基于人群的研究旨在分析大样本中几种形态学和体积上与iNPH相关的成像标志物，确定它们的分布、诊断准确性、建议截断值以及与iNPH症状的关联。方法：本横断面研究包括791名70岁的老年人，其中40名放射学上可能有iNPH (iNPHRadiol)， 751名无iNPH特征（参考文献）。MRI测量包括Evans指数（EI）、z-EI、脑室前、后裂比（BVRPC）、脑沟压迫、Sylvian裂扩大、胼胝体角、颞角直径、第三、第四脑室、中脑和脑桥。使用自动分割计算脑室、胼胝体和脑干的体积。ROC分析确定了成像标记的截止点。通过临床和自我报告评估症状。结果：参照组影像学标志物的中位值（95% CI）如下：EI: 0.27 (0.26-0.27), z-EI: 0.28 (0.26-0.31), BVRAC: 1.69 (1.48-1.90), BVRPC: 2.66（2.24-3.27）。在iNPHRadiol和参比组之间，大多数成像标记有显著差异。侧脑室容积与z-EI和BVR的相关性优于EI （Rs 0.81 vs 0.68）。z-EI、BVRAC和BVRPC鉴别iNPHRadiol的最佳临界值分别为0.32、1.36和1.83。临床症状与影像学指标有中度相关性（iNPHRadiol的Rs < 0.49, p < 0.01）。结论：我们报告了基于人群的参考值，并提出了inph相关成像标记和体积测量的截止值。Z-EI和BVR可能是评估iNPH患者心室增大的较好指标。iNPH的影像学指标与iNPH症状有中度相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Neuroradiology Journal NEUROIMAGING-

CiteScore

2.50

自引率

0.00%

发文量

101

期刊介绍： NRJ - The Neuroradiology Journal (formerly Rivista di Neuroradiologia) is the official journal of the Italian Association of Neuroradiology and of the several Scientific Societies from all over the world. Founded in 1988 as Rivista di Neuroradiologia, of June 2006 evolved in NRJ - The Neuroradiology Journal. It is published bimonthly.