The Evans’ Index revisited: New cut-off levels for use in radiological assessment of ventricular enlargement in the elderly
| Autor: | Geir Ringstad, Mona K. Beyer, Kari Wagner-Larsen, Christian M. Page, Per Kristian Eide, Valeria Vitelli, Eric Westman, Andrew Simmons, Maiken K. Brix |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Percentile Sensitivity and Specificity Healthy elderly Cerebral Ventricles 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Alzheimer Disease Reference Values Internal medicine medicine Humans Radiology Nuclear Medicine and imaging 10. No inequality Pathological Aged Aged 80 and over medicine.diagnostic_test business.industry Magnetic resonance imaging Organ Size General Medicine Magnetic Resonance Imaging Hydrocephalus Normal Pressure Surgery Ventricular volume Ventricular enlargement Radiological weapon Cardiology Female Evans index business Evans Index Alzheimer’s disease idiopathic normal pressure hydrocephalus 030217 neurology & neurosurgery |
| Zdroj: | Brix, M K, Westman, E, Simmons, A, Ringstad, G A, Eide, P K, Wagner-Larsen, K, Page, C M, Vitelli, V & Beyer, M K 2017, ' The Evans’ Index revisited : New cut-off levels for use in radiological assessment of ventricular enlargement in the elderly ', European journal of radiology . https://doi.org/10.1016/j.ejrad.2017.07.013 |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2017.07.013 |
| Popis: | Background and purpose: Assessment of ventricular enlargement is subjective and based on the radiologist’s experience. Linear indices, such as the Evans Index (EI), have been proposed as markers of ventricular volume with an EI ≥ 0.3 indicating pathologic ventricular enlargement in any subject. However, normal range for EI measured on magnetic resonance imaging (MRI) scans are lacking in healthy elderly according to age and sex. We propose new age and sex specific cut-off values for ventricular enlargement in the elderly population. Materials and methods: 534 participants (53% women) aged 65-84 years; 226 patients with Alzheimer’s disease (AD), and 308 healthy elderly controls (CTR) from the AddNeuroMed and ADNI studies were included. The cut-off for pathological ventricular enlargement was estimated from healthy elderly categorized into age groups of 5 years range and defined as EI 97,5 percentile (mean + 2SD). Cut-off values were tested on patients with Alzheimer’s disease and a small sample of patients with probable idiopathic normal pressure hydrocephalus (iNPH) to assess the sensitivity. Results: The range of the EI in healthy elderly is wide and 29% of the CTR had an EI of 0.3 or greater. The EI increases with age in both CTR and AD, and the overall EI for women were lower than for men (p < 0.001). New EI cut off values for male/female: 65-69 years 0.34/0.32, 70-74 years 0.36/0.33, 75-79 years 0.37/0.34 and 80-84 years 0.37/0.36. When applying the proposed cut-offs for EI in men and women aged 65 to 84, they differentiated between iNPH and CTR with a sensitivity of 80% and for different age and sex categories of AD and CTR with a sensitivity and specificity of 0–27% and 91-98%, respectively. Conclusion: The range of the EI measurements in healthy elderly is wide, and a cut-off value of 0.3 cannot be used to differentiate between normal and enlarged ventricles in individual cases. The proposed EI thresholds from the present study show good sensitivity for the iNPH diagnosis. |
| Databáze: | OpenAIRE |
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