Aims: The purpose of the study was to evaluate the reliability of our new visual scale for a quick atrophy assessment of parietal lobes on brain Magnetic Resonance Imaging (MRI) among different professionals. A good agreement would justify its use for differential diagnosis of neurodegenerative dementias, especially early-onset Alzheimer’s Disease (AD), in clinical settings.

Methods: The visual scale named the Parietal Atrophy Score (PAS) is based on a semi-quantitative assessment ranging from 0 (no atrophy) to 2 (prominent atrophy) in three parietal structures (sulcus cingularis posterior, precuneus, parietal gyri) on T1-weighted MRI coronal slices through the whole parietal lobes. We used kappa statistics to evaluate intra-rater and inter-rater agreement among four raters who independently scored parietal atrophy using PAS. Rater 1 was a neuroanatomist (JM), rater 2 was an expert in MRI acquisition and analysis (II), rater 3 was a medical student (OP) and rater 4 was a neurologist (DS) who evaluated parietal atrophy twice in a 3-month interval to assess intra-rater agreement. All raters evaluated the same 50 parietal lobes on brain MRI of 25 cognitively normal individuals with even distribution across all atrophy degrees from none to prominent according to the neurologist’s rating.

Results: Intra-rater agreement was almost perfect with the kappa value of 0.90. Inter-rater agreement was moderate to substantial with kappa values ranging from 0.43-0.86.

Conclusion: The Parietal Atrophy Score is the reliable visual scale among raters of different professions for a quick evaluation of parietal lobes on brain MRI within 1-2 minutes. We believe it could be used as an adjunct measure in differential diagnosis of dementias, especially early-onset AD.

目的：该研究的目的是评估我们的新视觉量表的可靠性，用于在不同专业人士的脑磁共振成像 (MRI) 上快速评估顶叶的萎缩。一个好的协议将证明其在临床环境中用于神经退行性痴呆，尤其是早发性阿尔茨海默病 (AD) 的鉴别诊断是合理的。

方法：名为顶叶萎缩评分 (PAS) 的视觉量表基于 T1 上三个顶叶结构（后回扣带、楔前叶、顶叶回）的半定量评估，范围从 0（无萎缩）到 2（显着萎缩） - 整个顶叶的加权 MRI 冠状切片。我们使用 kappa 统计来评估使用 PAS 独立评分顶叶萎缩的四位评分者的评分者内和评分者间的一致性。评分者 1 是神经解剖学家 (JM)，评分者 2 是 MRI 采集和分析 (II) 方面的专家，评分者 3 是医学生 (OP)，评分者 4 是神经科医生 (DS)，他在 3-月间隔来评估内部评估协议。

结果：评分者内的一致性几乎是完美的，kappa 值为 0.90。评分者间的一致性为中等至实质性，kappa 值范围为 0.43-0.86。

结论：顶叶萎缩评分是不同专业评分者之间可靠的视觉量表，可在 1-2 分钟内快速评估脑 MRI 上的顶叶。我们相信它可以用作痴呆鉴别诊断的辅助措施，尤其是早发性 AD。