Reliability study of white matter rating scale for the dementia and disability in Thai Elderly Project.
OBJECTIVE
To study the reliability of white matter rating scale on magnetic resonance imaging (MRI) of elderly patients in the urban community of Bangkok.


METHODS
One hundred elderly with clinical diagnosis of cognitive impairment in the urban community around Siriraj Hospital underwent cranial MRI according to the Dementia and Disability in Thai Elderly Project. The axial T1wi, T2wi, and fluid attenuated inversion recovery (FLAIR) were separately assessed by two neuroradiologists. The assessment included white matter change by using Scheltens' rating scale, atrophy, and evidence of infarction. The inter-rater agreements were analyzed.


RESULTS
The inter-rater agreement of periventricular hyperintensities, white matter, basal ganglion and infratentorial foci of hyperintensities were very good (ICC = 0.89-0.98). The agreement was good for central atrophy (Kw = 0.66) and moderate for cortical atrophy (Kw = 0.49). The silent infarction was found in the study population and divided into cortical (15%), subcortical (26%), brainstem (3%), and infratentorial infarction (8%).


CONCLUSIONS
White matter hyperintensities was an important radiological criteria for diagnosis of vascular dementia. Appropriate rating scale is necessary especially in research study. The authors found that Scheltens rating scale needed some training and slightly time consuming at the beginning but was a good reliable tool.
Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. oak_art@yahoo.com
Orasa
O
Chawalparit
Suwimon
S
Wonglaksanapimon
Dittapong
D
Songsaeng
Vorapun
V
Saenanarong
D000368:Aged; D044466:Asian People; D001284:Atrophy / Q000145:classification / Q000473:pathology; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology; D003704:Dementia / Q000473:pathology*; D015140:Dementia, Vascular / Q000473:pathology*; D003936:Diagnosis, Computer-Assisted; D004185:Disability Evaluation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D015588:Observer Variation; D015203:Reproducibility of Results; D013785:Thailand; D014505:Urban Population