title: [Reliability of quantifying vascular white matter brain lesions -- a contribution to reproducible quantitative diagnosis].
abstract: OBJECTIVE
  Microangiopathic lesions of the brain tissue correlate with the clinical diagnosis of vascular subcortical dementia. The "experience-based" evaluation is insufficient. Rating scales may contribute to reproducible quantification.
  
  
  METHODS
  In MRI studies of 10 patients, 9 neuroradiologists quantified vascular white matter lesions (WMLs) at two different points in time for 12 anatomically defined regions with respect to number, size and localization (score). For 9 observers and 10 studies, 90 intra-observer differences were obtained for each of the 12 WML scores. To calculate the inter-observer reliability, rating pairs were formed. Furthermore, 360 differences were computed for each score and rating for 12 anatomically defined WML scores, and the intraclass correlation (ICC) was calculated as a measure of agreement (reliability).
  
  
  RESULTS
  As to the intra-observer reliability, the median of the differences was 1.5 for the entire brain as opposed to 0 for defined brain regions. The corresponding values for the inter-observer reliability were 3 and 1, respectively. The mean intra-class correlation coefficient for the 10 studies was 0.88, whereas the mean interclass correlation concerning the inter-observer reliability was 0.70, with the first and second rating being averaged. The rating of each study took about 6 minutes.
  
  
  CONCLUSIONS
  The rating scale with high intra- and inter-observer reliability can dependably quantify WMLs and correlates with the clinical diagnosis of vascular dementia. Using a reliable rating scale, the diagnostic distinction of age-associated physiological vs. pathological size of the WML can make a contribution to the reproducible quantifiable diagnostic evaluation of vascular brain tissue lesions within the framework of dementia diagnostics.
authors.affiliation: Abteilung Neuroradiologie, ZI, Fakultät für klinische Medizin Mannheim der Universität Heidelberg. hentsche@zi-mannheim.de
authors.forename: F
authors.initials: F
authors.lastname: Hentschel
authors.forename: M
authors.initials: M
authors.lastname: Kreis
authors.forename: M
authors.initials: M
authors.lastname: Damian
authors.forename: M
authors.initials: M
authors.lastname: Diepers
authors.forename: C
authors.initials: C
authors.lastname: Disqué
authors.forename: I
authors.initials: I
authors.lastname: Dzialowski
authors.forename: H
authors.initials: H
authors.lastname: Kitzler
authors.forename: A
authors.initials: A
authors.lastname: Rodewald
authors.forename: T
authors.initials: T
authors.lastname: Struffert
authors.forename: S
authors.initials: S
authors.lastname: Trittmacher
authors.forename: P R
authors.initials: PR
authors.lastname: Wille
authors.forename: B
authors.initials: B
authors.lastname: Krumm
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D003627:Data Interpretation, Statistical; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D013997:Time Factors