OBJECTIVE: Periventricular leukomalacia (PVL) is the leading cause of disability in children with cerebral palsy (CP). Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique for detecting microstructural lesions of white matter. Fractional anisotropy (FA) is a widely used DTI index with clinical significance in children with CP. This study aims to estimate the reliability of FA for children with CP. DESIGN: Four observers measured FA values in 78 children with spastic CP from PVL. Region of interests (ROIs) were placed in three anatomical loci at each side: medial and lateral portions of posterior limb of internal capsule and ascending sensory tract. Intra- and interobserver reliability indices including intraclass correlation coefficient (ICC), standard error of measurement, smallest real difference percentage (SRD%), and limit of agreement using Bland-Altman analysis were examined. RESULTS: Intraobserver ICCs were 0.85 or greater in all ROIs, and SRD% ranged from 3.59 to 12.33%. Interobserver ICCs exceeded 0.90 in all ROIs, and the SRD% were less than 10%. The Bland-Altman analysis showed good intra- and interobserver agreements. The reliability was not affected by severity of impairment. CONCLUSIONS: Reliability of DTI-derived FA value using ROIs was satisfactory in children with PVL. Georg Thieme Verlag KG Stuttgart · New York.
OBJECTIVE:Periventricular leukomalacia (PVL) is the leading cause of disability in children with cerebral palsy (CP). Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique for detecting microstructural lesions of white matter. Fractional anisotropy (FA) is a widely used DTI index with clinical significance in children with CP. This study aims to estimate the reliability of FA for children with CP. DESIGN: Four observers measured FA values in 78 children with spastic CP from PVL. Region of interests (ROIs) were placed in three anatomical loci at each side: medial and lateral portions of posterior limb of internal capsule and ascending sensory tract. Intra- and interobserver reliability indices including intraclass correlation coefficient (ICC), standard error of measurement, smallest real difference percentage (SRD%), and limit of agreement using Bland-Altman analysis were examined. RESULTS: Intraobserver ICCs were 0.85 or greater in all ROIs, and SRD% ranged from 3.59 to 12.33%. Interobserver ICCs exceeded 0.90 in all ROIs, and the SRD% were less than 10%. The Bland-Altman analysis showed good intra- and interobserver agreements. The reliability was not affected by severity of impairment. CONCLUSIONS: Reliability of DTI-derived FA value using ROIs was satisfactory in children with PVL. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Moon Young Park; Doyeon Han; Jung Ho Lim; Min Kyung Shin; Young Rok Han; Dong Hwan Kim; Sungsoo Rhim; Kyung Sook Kim Journal: PLoS One Date: 2019-05-02 Impact factor: 3.240