1、cI|:1000-2790(2008)03-0273-047hMMRI j $s)ZE1 张秋娟1,杨军乐1, 2,郭佑民3,姚晓新4,徐 敏1, 2,张 静1,白芝兰1 (1YvD= D,710004, 2 gD, 710001, 3 nD Sv Db S,100020, 4 g D 710004)l :2007-06-18; s :2007-12-01 “: 8?1 “(2006k13-G7-6), g S/1 “(GG05140)YT:R .Tel:(010)85231720 Email:CJRTe:f l .D =,p V 3( =R ).Tel:(029)87679242 Email
2、:ZComparisonofvisualratingscalesforwhitematerlesionsonmagneticreso-nanceimagingZHANGQiu-Juan1, YANGJun-Le1, 2, GUOYou-Min3, YAOXiao-Xin4, XUMin1,2, ZHANGJing1, BAIZhi-Lan11ImagingCenter, SecondAfiliatedHospital, MedicalSchool,XianJiaotongUniversity, Xian710004, China, 2ImagingCen-ter, CentralHospita
3、lofXianCity, Xian 710001, China,3DepartmentofRadiology, BeijingChaoyangHospital, CapitalMedicalUniversity, Beijing100020, China, 4ImagingCenter,FourthHospitalofXianCity, Xian710004, China【Abstract】AIM:Tocompare7 widelyusedratingscalesforwhitematterlesions(WMLs)onMRI, toassessthecorrelationsamongthes
4、calesandtheinterrateragreementforeachscale, andtocalculatetheconversioncoefficientsofthescorebetweendif-ferentscales.METHODS:Weselectedrandomly50 patientswithvariousdegreesofWMLsonT2-FLAIRimaging.TheWMLswerescoredbytwotrainedratersusing7MRIratingscalesforWMLs.Spearmanrankcorrelation, Kappatestandreg
5、ressionanalysiswereapplied.RESULTS:Ahighcorrelationwasob-servedamongthe7 scales(correlationcoeficientsrangingfrom0.579to0.917, P0.585).Usingregressionanalysis, wedeterminednumericparameterstotransformthescoreof1scaletothecorrespondingscoreforeachoftheremainingscales, exceptforthescaleofAharon-Peretz
6、JandDeGrootJC.ThepredictivevaluesoftheseconversionsR2 rangedfrom0.5856 to0.8892.CONCLUSION:OurdatademonstratesahighcorelationamongtheconsideredvisualratingscalesforWMLsandabestinterrateragreementforthescaleofAharon-PeretzJ.【Keywords】whitematerlesions;magneticresonanceimaging;visualratingscale【K 1】 “
7、:1 7 7hM(WMLs)MRI j$s)ZE, Ns)WM1B,i9 WM .ZE: |50 MRIT2-FLAIRAUWMLs, D =sY7s)ZE WMLs s. j $s)WM1 NSpearman)M1s, WBsKappa_,YVBs9 s)WM .T: j $s)WMLs s ( 0.585).“Aharon-PeretzJs)DeGrootJCs),YVBs 5s)WM , “ R2S0.5856 0.8892. :7hMMRI j $s)W zM1,7 WAha-ron-PeretzJs)BKz.【1oM】脑白质病变;磁共振成像;视觉分级【m|】R8, R74 【DS M
8、 】A0 7hM(whitematerlesions,WMLs),97 ,CTMRIT2WI 7 = |h1.65 M CTMRI WMLs? 3 q , 75h、 #p.WMLs “5il “ - b#, ?Y “ - i vp. tpi V ? WMLs ZE1 1. “ -WMLs ZE j $s)8 . H8 M1 , j $s)e, av“. 7, j $s)WMLsS# , hM、| u s( 7 i periventricularwhitematerlesions, PVLs deepwhitematerlesions,DWMLs)ZEB, V ?ys)ZE NWMLs7T,yN
9、, NWMLss)WM1#B “5v“ A1.273 +Dv(JFourthMilMedUniv)2008, 29(3) htp:/1 ZE1.1 12005-07/2006-07, l“y 8#7 7 ?T7 T 7MRI_,iV |50 WMLs, M-60 ,/HqB (“: # vS ;s 4 ; T =?; 7.1.2 ZE1.2.1 脑白质病变视觉分级方法 Ds)ZE,Aharon-PeretzJs) 2 ,DeGrootJCs) 3,Fazekass) 4 ,Scheltens(Modified)s) 5 ,Ylikoskis) 6,Manolios) 7Mntyls) 1 7.
10、1.2.2 图像的采集及评价 GESigna1.5TH T 7?MR . T1-FLAIR,T2-FLAIRT2WI.5 mm, 1.5mm.WMLslT2-FLAIR, /T2WIm =H b、?5| u. M b D=sY7 j $s)ZE, T_WMLs s,i: c1 T.d9) :SPSS13.0 q. j $s)ZE NWMLs M1A_Spearman)M1s;LB s)WsM, rTR2(S01)V U;B j $s)ZE,4WB NKappa_.2 T2.1 7WMLs j $s)ZEWSpearman)M1s Aharon-PeretzJs)M1 ,DeGrootJCs)
11、4s)ZEFrazekas,Schelten(modilified),YlikoskiMntyl N 7 ihM zM1(rs0.6915).Frazekass)、Schelten(modilified)s)、Ylikoskis)、Mntyls)Manolios)W9zM1(rs0.748,V1).2.2 j $s)ZEWLBs Frazekass)、Schelten(modilified)s)、Ylikoskis)、Mntyls)Manolios)WBsnV2. y LBZ:Y=a+bX.YVZ Vs)WsM. Frazekass)ZEWMLs4s,YVZ VYlikoskis), sY=-
12、14.940+8.14004=17.62.V1 j $s)ZEWSpearman)M1sM XM YM1“ rsPAharon-PeretzJ DeGrootJC 0.739 0.0077Aharon-PeretzJ Frazekas(PVH) 0.652 0.0188Aharon-PeretzJ Schelten(modilified)(PVH) 0.579 0.0369Aharon-PeretzJ Ylikoski(PVH) 0.675 0.0149Aharon-PeretzJ Mntyl(PVH) 0.689 0.0130DeGrootJC Frazekas(PVH) 0.6915 0.
13、0062DeGrootJC Schelten(modilified)(PVH) 0.695 0.0122DeGrootJC Ylikoski(PVH) 0.820 0.0031DeGrootJC Mntyl(PVH) 0.823 0.0030Frazekas Schelten(modilified) 0.748 0.0131Frazekas Ylikoski 0.831 0.0058Frazekas Manolio 0.885 0.0033Frazekas Mntyl 0.806 0.0075Schelten(modilified) Ylikoski 0.833 0.0057Schelten(
14、modilified) Manolio 0.893 0.0030Schelten(modilified) Mntyl 0.917 0.0024Ylikoski Manolio 0.853 0.0047Ylikoski Mntyl 0.815 0.0069Manolio Mntyl 0.903 0.0027V2 j $s)ZE sWLBssYXsX aB“ b “ R2Frazekas Schelten(modilified) 2.6682 0.1514 0.5994Schelten(modilified) Frazekas -6.1600 3.9600Frazekas Ylikoski 2.7
15、189 0.0794 0.6463Ylikoski Frazekas -14.940 8.1400Frazekas Manolio 2.4556 0.3314 0.7422Manolio Frazekas -4.0400 2.2400Frazekas Mntyl 2.2614 0.4010 0.6336Mntyl Frazekas -1.6800 1.5800Schelten(modilified) Manolio 0.4882 1.8550 0.8892Manolio Schelten(modilified)-0.3937 0.4794Schelten(modilified) Mntyl -
16、0.9594 2.3147 0.8070Mntyl Schelten(modilified) 1.3318 0.3486Ylikoski Manolio 1.3047- 3.3580 0.7435Manolio Ylikoski 1.1645 0.2214Ylikoski Mntyl 0.1650- 3.9036 0.5856Mntyl Ylikoski 2.11633 0.1500Manolio Mntyl -0.0508 1.1066 0.7137Mntyl Manolio 1.5118 0.6450274 +Dv(JFourthMilMedUniv)2008, 29(3) http:/2
17、.3 4WWMLss)B N Bs)ZE4WB_TnV3.Aharon-Peretzs)BK(=0.862),Schelten(modilified)s)(=0.416)Yli-koskis)B (=0.411).V3 4WWMLss)Kappa_j $s)S95%CIAharon-PeretzJ 0.862 0.131 0.606 1.119DeGrootJC 0.656 0.169 0.325 0.988Fazekas 0.645 0.175 0.303 0.988Schelten(modilified) 0.416 0.161 0.101 0.731Ylikoski 0.411 0.16
18、2 0.093 0.729Manolio 0.585 0.166 0.260 0.909Mntyl 0.776 0.144 0.494 1.0573 ) “ -,WMLsXT5wS# k1s.yN,4B; ? N z V NZEA1. NZE j $s)8 . ? NWMLsS,A UWMLsZ 8 .8 3MRI 、 9 q !,7 O H, P $v“ “5 k sBK.WMLs j $s) 9 q, VCTMRI ,e、 y , a “5 h. = WMLs j $s)s3 : N 7 iWMLs(PVLs):Aharon-PeretzJs)DeGrootJCs);sY N 7 i(PV
19、Ls) 7= (DWMLs):Fazekass)、Schelten(modilified)s)、Ylikoskis)Mntyls);8 N 7hM:Manolios). TA Us)W ( zM1(rs0.5;P0.8).YVLBs ZEWsM1 , “ R2Kv0.8892,Kl0.5856. s)ZE,“ 1 I n ZEWM1,i ZE V V T. ?CAharon-Peretzs) WBKz(=0.862),Mntyls)Q(=0.776),Ylikoskis)(=0.416)Schelten(modili-fied)s)(=0.411)B .Aharon-Peretzs)BK V
20、? sZEe1. PVLs? 3s5), hMS.Lm ZE NPVLs, #DWMLs,#? QWMLs.Mntyls)ZEWBQAharon-Peretzs)(=0.776),7 O ZEWM1(M1“ rs0.8).Aharon-Peretzs) ,Mntyls) WMLs SsYPVLsDWMLs N, s98WMLs s.ZE NDWMLs H I nhM# “.V /|h1 “ 8?h1 ?Q S 9 .5Schelten(modili-fied)s) WB ,ZEX Aharon-Peretzs)Mntyls),NWMLs H I nhMvl#,7 O HNDWMLs “.V S
21、chelten(modilified)j $ sWMLs8WzM1 10 ,4UZEWMLs N V ? .9,7WMLss)ZE NWMLs ,7 OZEW ( zM1.yp 4 as)ZE.,4B zMntyls)Aharon-Peretzs); T1:_4WMLsZ# “5VCW1“,4Scheltens)(modilified) V ? .1 1 “ NZEWB, ?8 hMh MM “,# ? s)ZE NWMLsZ .B1 WMLs j $s)ZE8 “5VCWM1, j $s)ZE . gD4 LHq.【 ID】1 MntylR, ErkinjuntiT, SalonenO, e
22、tal.Variableagreementbe-tweenvisualratingscalesforwhitematerhyperintensitiesonMRI:Comparisonof13 ratingscalesinapoststrokecohortJ.Stroke,1997, 28:1614-1623.2 Aharon-PeretzJ,CummingsVL, HilMA.VasculardementiaanddementiaofAlzheimertype:Cognition, venticularsize, andleuko-araiosisJ.ArchNeurol, 1988, 45
23、:719-721.3 DeGrootJC, deLeeuwFE, OudkerkM, etal.Cerebralwhitemat-terlesionsandcognitivefunction.TheRoterdamScanStudyJ.AnnNeurol, 2000, 47:145-151.4 FranzF, JohnB.Chawluk, AbassA, etal.MRsignalabnormali-275 +Dv(JFourthMilMedUniv)2008, 29(3) htp:/tiesat1.5TinAlzheimersdementiaandnormalagingJ.AJNRAmJNe
24、uroradiol, 1987, 8:421-426.5 ScheltensP, BarkhofF, LeysD, etal.Asemiquantitativeratingscalefortheassessmentofsignalhyperintensitiesonmagneticreso-nanceimagingJ.JNeurolSci, 1993, 114:7-12.6 YlikoskiR, YlikoskiA, ErkinjuntiT, etal.Whitematerchangesinhealthyelderlypersonscorrelatewithatentionandspeedof
25、mentalprocessingJ.ArchNeurol, 1993, 50:818-824. 7 ManolioT, KronmalR, BurkeG, etal.MagneticResonanceabnor-malitiesandcardio-vasculardiseaseinolderadults:Thecardiovas-cularhealthstudyJ.Stroke, 1994, 25:318-327.8 PrinsND,vanStraatenECW,vanDijkEJ, etal.Measuringprogres-sionofcerebralwhitematerlesionson
26、MRI:Visualratingandvolu-metricsJ.Neurology, 2004, 62:1533-1539. 9 ZhangQJ, GuoYM, ZhangGJ, etal.CorelativefactorsofcognitiveimpairmentinpatientswithlacunarinfarctsJ.AcadJXianJiao-tongUniv, 2007, 1:86-90.10 KapelerP, BarberR, VermeulenRJ, etal.Visualratingofage-re-latedwhitematerchangesonmagneticreso
27、nanceimagingscalecom-parison, interateragreement, andcorelationswithquantitativemeasurementsJ.Stroke, 2003, 34:441-445.I m cI|:1000-2790(2008)03-0276-01!hZE HBVh“rT4张 嵘,范珊红 ( +DvDD 5 S, 710038)l :2007-11-06; s :2007-12-03Te:f .5 =.Tel:(029)84777045 Email:【1oM】消毒;胃镜;肝炎,乙型【m|】R187.7【DS M 】B0 D XB1 35,
28、h%hV,_ (A、A、FA,h.l, v1,#_ , P N, + q, h V %h.l ,/D =W2-3.)hZEhrT4, 52 PhZE,4!hrT.1 ZE1.1 对象 4yh7_52 ,1 pHBV, O_. _, b!h -,sY 3 20mL !_Y, = | b!h - !A. !, = |20mL !A.1.2 方法1.2.1 b!h _, ( # !A !V “*A#A,i !_Y, HW30s, 20mL/L= h4500mg/Lc oh4 ,S/N2.1 H,HBsAg F_T ._ H !#|v.1.2.3 HBV-DNA; PCR_ _ k4#_N, ( 4,
29、i T.2 T 52 , bHBsAg (,HBV-DNA (4.7108 copg/mL.hA b! -HBsAg(+)37,HBsAg(-)15 ,HBV-DNA(+)39 ,HBV-DNA(-)13 ,HBV-DNA104 copg/mL(-) .20mL/L= F#c ohAF b!HBsAg(+)0 ,HBsAg(-) 26 , HBV-DNA(+)sY1 2 , HBV-DNA(-)sY25 4 . b!HBsAg(-)#HBV-DNA(-)sY26 25 ,HBV-DNA()1 .3 ) TA U, 52 V , HBsAg (+),HBV-DNA (4.7108 copg/mL
30、.tV_ ,Y, V A b!, HBsAg q r71% 52 HbsAg(+)37 ,HBV-DNA qr75% 52 HBV-DNA(+)39 ,HBV-DNAK Vr10109copg/mL). PhAh, q A/, FZEhF !, 20mL/L= F (-),c ohAF1 VP. L4 U ,hA b!、h、 !、V, _Ys,+YF _h.yN,ypHBV_, ah HW, h, Hyp|PCRB 2 ZET b!hB_ m 4.【 ID】1 . .YhD.l5J .D , 1991, 1(5)26-27.2z , ,l,.= S m )rT L i NJ. g 8D, 2004, 12(4)188-190.3 , ,8 ,. g 8 hrTJ.D , 2001, 11(6)448-449.4 ,u , *,. g 8 hrTJ.D , 2004, 14(2)184-196.I ?276 +Dv(JFourthMilMedUniv)2008, 29(3) http:/
