Practical one-dimensional measurements of age-related brain atrophy are validated by 3-dimensional values and clinical outcomes: a retrospective study.
BACKGROUND
Age-related brain atrophy has been represented by simple 1-dimensional (1-D) measurements on computed tomography (CT) for several decades and, more recently, with 3-dimensional (3-D) analysis, using brain volume (BV) and cerebrospinal fluid volume (CSFV). We aimed to show that simple 1-D measurements would be associated with 3-D values of age-related atrophy and that they would be related to post-traumatic intracranial hemorrhage (ICH).


METHODS
Patients ≥60 years with head trauma were classified with central atrophy (lateral ventricular body width >30 mm) and/or cortical atrophy (sulcus width ≥2.5 mm). Composite atrophy was the presence of central or cortical atrophy. BV and CSFV were computed using a Siemens Syngo workstation (VE60A).


RESULTS
Of 177 patients, traits were age 78.3 ± 10, ICH 32.2%, central atrophy 39.5%, cortical atrophy 31.1%, composite atrophy 49.2%, BV 1,156 ± 198 mL, and CSFV 102.5 ± 63 mL. CSFV was greater with central atrophy (134.4 mL), than without (81.7 mL, p < 0.001). BV was lower with cortical atrophy (1,034 mL), than without (1,211 mL; p < 0.001). BV was lower with composite atrophy (1,103 mL), than without (1,208 mL; p < 0.001). CSFV was greater with composite atrophy (129.1 mL), than without (76.8 mL, p < 0.001). CSFV÷BV was greater with composite atrophy (12.3%), than without (6.7%, p < 0.001). Age was greater with composite atrophy (80.4 years), than without (76.3, p = 0.006). Age had an inverse correlation with BV (p < 0.001) and a direct correlation with CSFV (p = 0.0002) and CSFV÷BV (p < 0.001). ICH was greater with composite atrophy (49.4%), than without (15.6%; p < 0.001; odds ratio = 5.3). BV was lower with ICH (1,089 mL), than without (1,188 mL; p = 0.002). CSFV÷BV was greater with ICH (11.1 %), than without (8.7%, p = 0.02). ICH was independently associated with central atrophy (p = 0.001) and cortical atrophy (p = 0.003).


CONCLUSIONS
Simple 1-D measurements of age-related brain atrophy are associated with 3-D values. Clinical validity of these methods is also supported by their association with post-injury ICH. Intracranial 3-D software is not available on many CT scanners and can be cumbersome, when available. Simple 1-D measurements, using the study methodology, are a practical method to objectify the presence of age-related brain atrophy.
Trauma/Critical Care Services, St. Elizabeth Youngstown Hospital, 1044 Belmont Avenue, Youngstown, OH, 44501, USA. dunham.michael@sbcglobal.net.
C Michael
CM
Dunham
Division of Radiology, St. Elizabeth Youngstown Hospital, 1044 Belmont Avenue, Youngstown, OH, 44501, USA.
Albert J
AJ
Cook
Division of Radiology, St. Elizabeth Youngstown Hospital, 1044 Belmont Avenue, Youngstown, OH, 44501, USA.
Alaina M
AM
Paparodis
Trauma/Critical Care Services, St. Elizabeth Youngstown Hospital, 1044 Belmont Avenue, Youngstown, OH, 44501, USA.
Gregory S
GS
Huang
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D001284:Atrophy / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D054928:Validation Studies as Topic
Brain atrophy; CT imaging; Traumatic intracranial hemorrhage