Related Experiment Video
Updated: Jul 1, 2025
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Enhancing Diagnostic Accuracy Through Neuroimaging Revisions in Pediatric Pseudotumor Cerebri Syndrome: A
Amira Masri1, Nosaiba Al Ryalat2, Azmy Hadidy2
1Faculty of Medicine, Department of Pediatrics, Division of Child Neurology, The University of Jordan, Amman, Jordan.
Insights
Re-reviewing neuroimages significantly improves the diagnosis of pseudotumor cerebri syndrome (PTCS) in children. This detailed analysis enhances the detection of key findings, improving patient care.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Neuro-ophthalmology
Background:
- Pseudotumor cerebri syndrome (PTCS) is a condition characterized by increased intracranial pressure in children.
- Accurate neuroimaging is crucial for diagnosing PTCS and identifying associated findings.
Purpose of the Study:
- To evaluate the impact of neuroradiologist re-review on identifying neuroimaging findings in pediatric PTCS.
- To assess the reliability of image interpretation through inter- and intraclass correlation.
Main Methods:
- Cross-sectional study of 48 children (<18 years) diagnosed with PTCS.
- Independent re-review of neuroimages by two neuroradiologists.
- Comparison of revised reports with initial reports and analysis of inter-/intraclass correlation.
Main Results:
- Initial reports under-identified PTCS findings (54.1%); re-review increased detection to 91.6%.
- Perioptic space distention was the most common finding post-revision (76%).
- Findings like posterior globe flattening, empty sella, Meckel cave narrowing, and pituitary stalk displacement were identified, improving diagnostic accuracy.
Conclusions:
- Image revision significantly enhances the diagnostic yield for PTCS in children.
- High inter- and intraclass correlations confirm the reliability of the re-review process.
- Meticulous neuroimage analysis is vital for accurate PTCS diagnosis and management.
Background:
This cross-sectional study aimed to report all neuroimaging findings suggestive of raised intracranial pressure in children with pseudotumor cerebri syndrome (PTCS), before and after re-review by two neuroradiologists.
Methods:
We included 48 children aged <18 years diagnosed with PTCS between 2016 and 2021. Clinical and radiological data were obtained from their medical files. Two neuroradiologists independently re-reviewed all neuroimages, and the average of their assessments was compared with the initial neuroimaging reports; an additional review was done to analyze inter- and intraclass correlation.
Results:
The initial neuroimaging reports showed under-reporting of findings, with only 26 of 48 (54.1%) patients identified with abnormal reports. After revision, the proportion of the reported findings increased to 44 of 48 (91.6%). Distention of the perioptic space was the most commonly reported finding after revision (36.5 of 48; 76%). Flattening of the posterior globe and empty sella were initially under-reported but improved after revision. Moreover, several findings suggestive of increased intracranial pressure not mandated by Friedman criteria were identified, such as narrowing of the Meckel cave, posterior displacement of the pituitary stalk, and narrowing of the cavernous sinus. Analysis of associations between neuroimaging findings and demographic and clinical characteristics yielded no statistically significant results. The inter- and intraclass correlation results demonstrated a significant agreement between raters and within each rater's assessment (P < 0.05).
Conclusions:
This study highlights the impact of image revision in enhancing PTCS diagnosis. Intra- and interclass correlations underscore the reliability of the review process, emphasizing the importance of meticulous image analysis in clinical practice.
More Related Videos
03:13Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
Published on: June 28, 2024
12:50Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly
Published on: April 14, 2014