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首页> 外文期刊>Journal of neurology >White matter hyperintensities and rating scales-observer reliability varies with lesion load.
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White matter hyperintensities and rating scales-observer reliability varies with lesion load.

机译：白质过高和等级量表-观察者的可靠性随病变负荷而变化。

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BACKGROUND: Cerebral white matter hyperintensities (WMHs) are common in older people. Their presence correlates with cognitive decline and vascular risk factors. Various scales have been developed to quantify the amount and type of WMH, but with few observer reliability studies. We evaluated several scales in different cohorts to determine their observer reliability. METHODS: Two observers independently rated T2-weighted MR images from five groups (total n = 494: normal older subjects [97]; patients with minor stroke [221]; young insulin dependent diabetics [141]; maturity onset diabetics [10]; and hepatic encephalopathy [25]), using seven rating scales (Breteler, Fazekas, Longstreth, Mirsen, Shimada, Van Swieten and Wahlund). Inter-observer reliability was determined using Kappa statistics. RESULTS: Patients with maturity onset diabetes had the most WMHs and young insulin-dependent diabetics the least. Inter-observer reliability varied with the amount of WMH. In maturity onset diabetics (most WMHs) the weighted Kappas were: Breteler 0.74; Fazekas 0.89 and 0.72; Van Swieten 0.76 and 0.88; and in young insulin-dependent diabetics (least WMH): Breteler 0.3; Fazekas 0.2 and 0.24; Van Swieten 0.39 and 0.30. These findings were consistent across the groups. CONCLUSION: WMH rating scale performance varied with WMH prevalence, and hence with subject cohort. In patients with most WMHs the apparent better kappas may reflect a "ceiling effect" rather than true better agreement. These factors should be considered in studies where risk factors for, or associations with, the early development of WMHs are being determined.
机译：背景：脑白质高信号（WMH）在老年人中很常见。它们的存在与认知能力下降和血管危险因素相关。已开发出各种量表来量化WMH的数量和类型，但很少进行观察者可靠性研究。我们评估了不同队列中的几种量表，以确定其观察者的可靠性。方法：两名观察员分别对五个组的T2加权MR图像进行了评分（总n = 494：正常年龄的受试者[97];中风的患者[221];年轻的胰岛素依赖型糖尿病患者[141];成熟期糖尿病患者[10];和肝性脑病[25]），使用七个评分量表（Breteler，Fazekas，Longstreth，Mirsen，Shimada，Van Swieten和Wahlund）。使用Kappa统计信息确定观察者之间的可靠性。结果：成熟期糖尿病患者的WMH最多，而年轻的胰岛素依赖型糖尿病最少。观察者之间的可靠性随WMH数量的变化而变化。在成熟期糖尿病患者（大多数WMH）中，加权Kappas为：Breteler 0.74;法兹卡斯0.89和0.72; Van Swieten 0.76和0.88;在年轻的胰岛素依赖型糖尿病患者中（最低WMH）：Breteler 0.3; Fazekas 0.2和0.24;范·斯威腾（Van Swieten）0.39和0.30。这些发现在各组之间是一致的。结论：WMH评分量表的表现随WMH患病率的变化而变化，因此随受试者队列的变化而变化。在大多数WMH患者中，明显更好的kappas可能反映出“天花板效应”，而不是真正更好的一致性。在确定WMH早期发展的危险因素或相关因素的研究中应考虑这些因素。

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