基于CT的DESH量表评分在特发性正常压力脑积水中的应用

Application of CT-based disproportionately enlarged subarachnoidspace hydrocephalus scale score in idiopathic normal pressure hydrocephalus

目的:探讨基于CT的DESH量表评分在特发性正常压力脑积水中的应用价值。方法:回顾性分析29例疑似iNPH患者临床及影像学资料,所有患者治疗前均行头颅CT及MR检查。分别对样本的头颅CT及MR图像进行DESH量表评分,比较CT与MR的DESH量表各参数的一致性,包括侧脑室扩大指数(Evans'index,EI)、侧裂池扩大、大脑凸面挤压效应、胼胝体角(CA)及局部脑沟扩张的评分。结果:iNPH患者CT与MR的DESH量表各评分参数组内相关系数如下:ICC EI为0.928,ICC侧脑室评分为0.905,ICC CA为0.855,ICC CA评分为0.743,ICC侧裂池评分为0.983,ICC凸面挤压评分为0.984,ICC局部脑沟评分0.814,ICC DESH总分0.914。结论:CT与MR图像的DESH量表各参数评分具有良好的一致性,头颅薄层CT的三维重建图像可应用于iNPH患者DESH量表评分。

Objective:To investigate the value of CT-based disproportionately enlarged subarachnoidspace hydrocephalus(DESH)scale score for idiopathic normal pressure hydrocephalus(iNPH).Methods:The clinical and imaging data of 29 patients with suspected iNPH were retrospectively analyzed.All patients underwent CT and MR examination before treatment.The DESH scale parameters were scored on the CT and MR images respectively and the intraclass correlation coefficients(ICCs)was calculated.The parameters included Evans'index(EI),scores of lateral ventricles dilation,sylvian fissure dilation,tight high convexity,callosal angle(CA)and focal sulcal dilation.Results:The ICCs between DESH scale scores of CT and MR were mostly greater than 0.9(ICC EI=0.928,ICC ventriculomegaly=0.905,ICC sylvian fissures dilation=0.983,ICC tight high convexity=0.984,ICC total score=0.914).The ICCs of CA,CA score and focal sulcal dilation were between 0.7 and 0.9.Conclusion:The DESH scale score for iNPH patients is also applicable to three-dimensional thin-wall CT of the brain.