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The idiopathic normal-pressure hydrocephalus Radscale: a radiological scale for structured evaluation.
K Kockum1, O Lilja-Lund1, E-M Larsson2
1Department of Pharmacology and Clinical Neuroscience, Neurology, Östersund, Umeå University, Umeå, Sweden.
European Journal of Neurology
|December 28, 2017
Summary
A new radiological scale, the iNPH Radscale, was developed to assess idiopathic normal-pressure hydrocephalus (iNPH) using brain imaging. This scale shows a significant correlation with clinical symptoms, aiding in iNPH diagnosis.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Idiopathic normal-pressure hydrocephalus (iNPH) diagnosis relies on imaging, but a structured assessment of radiological signs is lacking.
- Current diagnostic methods for iNPH require a comprehensive radiological evaluation tool.
Purpose of the Study:
- To construct a radiological scale (iNPH Radscale) based on morphological signs of iNPH.
- To compare the developed radiological scale with existing clinical symptoms of iNPH.
Main Methods:
- A prospective, population-based study included 168 individuals who underwent brain CT and neurological examination.
- Two radiologists independently evaluated eight radiological parameters, including Evans' index and ventricular size.
- Clinical symptoms were assessed using Hellström's iNPH scale.
Main Results:
- Seven radiological parameters, excluding ventricular roof bulging, were significantly associated with clinical iNPH symptoms.
- The iNPH Radscale score (0-12) demonstrated a significant correlation (r=0.55, P<0.001) with clinical symptoms.
- High inter-rater agreement (ICC 0.74-0.97) was observed for the evaluated radiological parameters.
Conclusions:
- The iNPH Radscale offers a structured approach for radiological assessment in iNPH diagnosis.
- A high iNPH Radscale score combined with clinical symptoms should prompt further evaluation for potential shunt surgery.
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