title: Reliability of a novel, semi-quantitative scale for classification of structural brain magnetic resonance imaging in children with cerebral palsy.
abstract: OBJECTIVE
  To describe the development of a novel rating scale for classification of brain structural magnetic resonance imaging (MRI) in children with cerebral palsy (CP) and to assess its interrater and intrarater reliability.
  
  
  METHODS
  The scale consists of three sections. Section 1 contains descriptive information about the patient and MRI. Section 2 contains the graphical template of brain hemispheres onto which the lesion is transposed. Section 3 contains the scoring system for the quantitative analysis of the lesion characteristics, grouped into different global scores and subscores that assess separately side, regions, and depth. A larger interrater and intrarater reliability study was performed in 34 children with CP (22 males, 12 females; mean age at scan of 9 y 5 mo [SD 3 y 3 mo], range 4 y-16 y 11 mo; Gross Motor Function Classification System level I, [n=22], II [n=10], and level III [n=2]).
  
  
  RESULTS
  Very high interrater and intrarater reliability of the total score was found with indices above 0.87. Reliability coefficients of the lobar and hemispheric subscores ranged between 0.53 and 0.95. Global scores for hemispheres, basal ganglia, brain stem, and corpus callosum showed reliability coefficients above 0.65.
  
  
  CONCLUSIONS
  This study presents the first visual, semi-quantitative scale for classification of brain structural MRI in children with CP. The high degree of reliability of the scale supports its potential application for investigating the relationship between brain structure and function and examining treatment response according to brain lesion severity in children with CP.
authors.affiliation: Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Fiori
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cioni
authors.forename: Katrjin
authors.initials: K
authors.lastname: Klingels
authors.forename: Els
authors.initials: E
authors.lastname: Ortibus
authors.forename: Leen
authors.initials: L
authors.lastname: Van Gestel
authors.forename: Stephen
authors.initials: S
authors.lastname: Rose
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.forename: Andrea
authors.initials: A
authors.lastname: Guzzetta
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology*; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015203:Reproducibility of Results; D012720:Severity of Illness Index