Grading white matter lesions on CT and MRI: a simple scale

We developed and tested a simple three-point scale for grading white matter lesions in anterior and posterior regions of the brain. Twenty four CT scans and 24 MRI scans were separately judged by 11 and five observers, respectively, on the presence and severity of white matter lesions. The observers...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1990-12, Vol.53 (12), p.1080-1083
Main Authors: van Swieten, J C, Hijdra, A, Koudstaal, P J, van Gijn, J
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brain - diagnostic imaging
Brain - pathology
Brain Diseases - classification
Brain Diseases - diagnosis
Brain Diseases - diagnostic imaging
Cross-Sectional Studies
Data Interpretation, Statistical
Humans
Investigative techniques, diagnostic techniques (general aspects)
Ischemic Attack, Transient - classification
Ischemic Attack, Transient - diagnosis
Ischemic Attack, Transient - diagnostic imaging
Longitudinal Studies
Magnetic Resonance Imaging - statistics & numerical data
Medical sciences
Nervous system
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Tomography, X-Ray Computed - statistics & numerical data
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Summary:We developed and tested a simple three-point scale for grading white matter lesions in anterior and posterior regions of the brain. Twenty four CT scans and 24 MRI scans were separately judged by 11 and five observers, respectively, on the presence and severity of white matter lesions. The observers were radiologists and neurologists. For CT scans, these periventricular changes were graded according to their extent as absent, or partly involving the white matter, or extending up to the subcortical region. The MRI lesions were graded as no lesion or only a single one, multiple focal lesions, and multiple confluent lesions. The pairwise agreements of all possible combinations of observers for each scan were corrected for chance (kappa statistics; maximal agreement 1.0). The weighted kappa value, for anterior and posterior regions combined, was 0.63 for CT scans, and 0.78 for MRI scans. This three-point scale for two separate regions seems suitable as a basis for cross-sectional or longitudinal studies of large series of patients.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.53.12.1080