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Clinical Article
Diagnostic efficacy of novel imaging markers and its correlation with clinical symptoms for idiopathic normal pressure hydrocephalus
HUANG Wenjun  FANG Xuhao  LI Shihong  MAO Renling  YE Chuntao  LIU Wei  LIN Guangwu 

Cite this article as: Huang WJ, Fang XH, Li SH, et al. Diagnostic efficacy of novel imaging markers and its correlation with clinical symptoms for idiopathic normal pressure hydrocephalus[J]. Chin J Magn Reson Imaging, 2021, 12(12): 12-17, 23. DOI:10.12015/issn.1674-8034.2021.12.003.


[Abstract] Objective To evaluate the diagnosis efficacy of imaging markers (including linearity, angle, volume and the ratio) of idiopathic normal pressure hydrocephalus (iNPH) and their relationship with clinical symptoms. Materials and Methods: The novel imaging markers, frontal horn diameter (FHD), inner skull diameter (ISD), cella media width (CMW), maximum supratentorial intracranial diameter (MSID), supraventricular width (SVW), callosal-ventricular distance (CVD), callosal-commissural distance (CCD), temporal horn width (THW), callosal height (CH), Evans index (EI), z-Evans index (ZEI), frontal horn vertical diameter (FHVD), brain-to-ventricle ratio (BVR), obtained from 3.0 T brain magnetic resonance imaging in twenty-two patients with idiopathic normal pressure hydrocephalus and twenty-six healthy elders. Diagnostic performance of imaging markers was studied by using receiver operating characteristic (ROC) analysis, t-statistic and Logistic regression models. To analyze the correlation between the clinical symptoms (including gait, cognition and urination function) of the patients diagnosed with INPH and the imaging indexes.Results EI, CMW, CCD,FHVD, CVD, THW and CH, ZEI showed high specificity (P<0.001). CMW showed the highest discriminatory power between iNPH and healthy control group (AUC=0.985), followed by EI (AUC=0.981) and THW (AUC=0.946). CMW and THW had the most statistically significant difference between the iNPH group and the normal age group. ZEI, FHVD and CH were correlated with preoperative idiopathic normal pressure hydrocephalus grade scale (iNPHGS) micturition score.Conclusion The best diagnostic performance among these new imaging markers is EI, CMW, CCD and THW. Thus it can be inferred that lateral ventricular dilatation is more in the Z-axis direction. ZEI, FHVD and CH were correlated with preoperative urination.
[Keywords] idiopathic normal pressure hydrocephalus;magnetic resonance imaging;dementia;imaging marker;diagnostic performance

HUANG Wenjun1   FANG Xuhao2   LI Shihong1   MAO Renling2   YE Chuntao1   LIU Wei1   LIN Guangwu1*  

1 Department of Medical Imaging, Huadong Hospital affiliated to Fudan University, Shanghai 200040, China

2 Neurosurgery department, Huadong Hospital affiliated to Fudan University, Shanghai 200040, China

Lin GW, E-mail: lingw01000@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 81771816); Shanghai Municipal Population and Family Planning Commission (No. 201740003).
Received  2021-05-20
Accepted  2021-11-09
DOI: 10.12015/issn.1674-8034.2021.12.003
Cite this article as: Huang WJ, Fang XH, Li SH, et al. Diagnostic efficacy of novel imaging markers and its correlation with clinical symptoms for idiopathic normal pressure hydrocephalus[J]. Chin J Magn Reson Imaging, 2021, 12(12): 12-17, 23. DOI:10.12015/issn.1674-8034.2021.12.003.

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