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A new index for assessing cerebral ventricular volume in idiopathic normal-pressure hydrocephalus: a comparison with Evans’ index

  • Diagnostic Neuroradiology
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Abstract

Purpose

To recommend a new simple and explicit index termed the anteroposterior diameter of the lateral ventricle index (ALVI) for assessing brain ventricular size in neuroimaging and to compare Evans index (EI) between idiopathic normal pressure hydrocephalus (iNPH) patients and age-matched healthy elderly subjects.

Methods

Retrospective measurements of ventricular volume (VV), relative VV (RVV), the EI, and the ALVI were taken from thin-section CT scans for 23 pre-shunt-insertion iNPH patients and 62 age-matched healthy elderly volunteers. The area under the receiver operating characteristic (ROC) curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to assess the effectiveness of ALVI scores for predicting VV.

Results

The correlations between VV or RVV and ALVI scores (VV, r = 0.957; RVV, r = 0.983) were significantly stronger than the corresponding correlations with EI scores (VV, r = 0.843; RVV, r = 0.840). The AUC for ALVI scores was significantly greater than the AUC for EI scores. Furthermore, with the inclusion of the ALVI, the NRI value was 0.14 and the IDI value was 0.14; these improvements were also statistically significant.

Conclusion

The ALVI is a more accurate and more explicitly defined marker of VV than the EI and assesses ventricular enlargement effectively. We suggest that ventricular enlargement of the healthy elderly be defined by ALVI > 0.50.

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Funding

This study was funded by the Project of Shenzhen International Cooperation Foundation (GJHZ20180926165402083).

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center; Shenzhen Second People’s Hospital, 3002 SunGang Road West, Shenzhen, 518035, China

    Wenjie He, Xi Zhou & Jun Xia

  2. Department of Neurosurgery, Huadong Hospital, Fudan University, 221 West Yan’an Road, Shanghai, China

    Xuhao Fang, Xing Gao, Renling Mao & Yanqing Hua

  3. Department of Radiology, Huadong Hospital, Fudan University, 221 West Yan’an Road, Shanghai, China

    Xiaowei Wang & Pan Gao

  4. Department of Radiology, Wayne State University, Detroit, MI, 48201, USA

    Jiani Hu

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  1. Wenjie He
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  2. Xuhao Fang
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  3. Xiaowei Wang
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  4. Pan Gao
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  5. Xing Gao
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  6. Xi Zhou
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  7. Renling Mao
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  8. Jiani Hu
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  9. Yanqing Hua
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  10. Jun Xia
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Correspondence to Jun Xia.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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He, W., Fang, X., Wang, X. et al. A new index for assessing cerebral ventricular volume in idiopathic normal-pressure hydrocephalus: a comparison with Evans’ index. Neuroradiology 62, 661–667 (2020). https://doi.org/10.1007/s00234-020-02361-8

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  • DOI: https://doi.org/10.1007/s00234-020-02361-8

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