Reliability and interobserver variability of a grading system of ventricular distension in dogs

IntroductionInternal hydrocephalus is the most common malformation of the central nervous system in dogs. Although the grades of ventricular distension have importance for long-term prognosis, there is no standard classification scheme describing the grade of the ventricular distension in dogs.Mater...

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Main Authors: Adriana Czerwik, Martin Jürgen Schmidt, Agnieszka Olszewska, Steven Hinz, Kathrin Büttner, Daniela Farke
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-11-01
Series:Frontiers in Veterinary Science
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fvets.2023.1271545/full
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author Adriana Czerwik
Martin Jürgen Schmidt
Agnieszka Olszewska
Steven Hinz
Kathrin Büttner
Daniela Farke
author_facet Adriana Czerwik
Martin Jürgen Schmidt
Agnieszka Olszewska
Steven Hinz
Kathrin Büttner
Daniela Farke
author_sort Adriana Czerwik
collection DOAJ
description IntroductionInternal hydrocephalus is the most common malformation of the central nervous system in dogs. Although the grades of ventricular distension have importance for long-term prognosis, there is no standard classification scheme describing the grade of the ventricular distension in dogs.Materials and methodsMagnetic resonance imaging (MRI) scans from 147 dogs of various breed, sex, skull conformation, and weight were reviewed retrospectively and blinded between three observers. Based on objectively assessable morphologic characteristics, the lateral cerebral ventricles were graded as normal, minimally, mildly, moderately, severely enlarged or end stage (grade 0 to grade 5), respectively. Evans’ index or the ventricle brain index was also measured in all animals. Interobserver agreement between a very experienced, experienced, and unexperienced person was evaluated by the Spearman coefficient and kappa tests. Additionally, correlation to the ventricle brain index was determined using the Spearman coefficient and F-tests.ResultsThe Spearman correlation coefficient reached a very strong correlation (r = 0.97) between the experienced and very experienced observer and a strong correlation (r = 0.91) between the very experienced and unexperienced observer. The kappa value revealed excellent interobserver agreement between the very experienced and experienced observers (weighted kappa 0.91) and moderate between the very experienced and unexperienced observers (weighted kappa 0.75). The ventricular-brain index correlated (r = 0.94, Spearman coefficient test) with the grading system, indicating that a more elevated ratio was related to a more advanced degree of ventricular enlargement. The interobserver agreement with regard to the grade between the neurologist in training and a board-certified neurologist was excellent and between the board-certified neurologist and general practitioner achieved lower values.ConclusionThe presented MRI-based grading of ventricular enlargement is a reliable and functional method for an objective grading of the ventricular system in dogs. Some experience in MRI and brain anatomy is needed for interpretation and grading.
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spelling doaj.art-db6fd760592d4223b72bf342ad190c0f2023-11-23T05:20:53ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692023-11-011010.3389/fvets.2023.12715451271545Reliability and interobserver variability of a grading system of ventricular distension in dogsAdriana Czerwik0Martin Jürgen Schmidt1Agnieszka Olszewska2Steven Hinz3Kathrin Büttner4Daniela Farke5Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, GermanyDepartment of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, GermanyDepartment of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, GermanySmall Animal Veterinary Practice Westpark, Wettenberg, GermanyUnit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, GermanyDepartment of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, GermanyIntroductionInternal hydrocephalus is the most common malformation of the central nervous system in dogs. Although the grades of ventricular distension have importance for long-term prognosis, there is no standard classification scheme describing the grade of the ventricular distension in dogs.Materials and methodsMagnetic resonance imaging (MRI) scans from 147 dogs of various breed, sex, skull conformation, and weight were reviewed retrospectively and blinded between three observers. Based on objectively assessable morphologic characteristics, the lateral cerebral ventricles were graded as normal, minimally, mildly, moderately, severely enlarged or end stage (grade 0 to grade 5), respectively. Evans’ index or the ventricle brain index was also measured in all animals. Interobserver agreement between a very experienced, experienced, and unexperienced person was evaluated by the Spearman coefficient and kappa tests. Additionally, correlation to the ventricle brain index was determined using the Spearman coefficient and F-tests.ResultsThe Spearman correlation coefficient reached a very strong correlation (r = 0.97) between the experienced and very experienced observer and a strong correlation (r = 0.91) between the very experienced and unexperienced observer. The kappa value revealed excellent interobserver agreement between the very experienced and experienced observers (weighted kappa 0.91) and moderate between the very experienced and unexperienced observers (weighted kappa 0.75). The ventricular-brain index correlated (r = 0.94, Spearman coefficient test) with the grading system, indicating that a more elevated ratio was related to a more advanced degree of ventricular enlargement. The interobserver agreement with regard to the grade between the neurologist in training and a board-certified neurologist was excellent and between the board-certified neurologist and general practitioner achieved lower values.ConclusionThe presented MRI-based grading of ventricular enlargement is a reliable and functional method for an objective grading of the ventricular system in dogs. Some experience in MRI and brain anatomy is needed for interpretation and grading.https://www.frontiersin.org/articles/10.3389/fvets.2023.1271545/fullcanine hydrocephalusmagnetic resonance imagingVPSgrading systemventriculomegaly
spellingShingle Adriana Czerwik
Martin Jürgen Schmidt
Agnieszka Olszewska
Steven Hinz
Kathrin Büttner
Daniela Farke
Reliability and interobserver variability of a grading system of ventricular distension in dogs
Frontiers in Veterinary Science
canine hydrocephalus
magnetic resonance imaging
VPS
grading system
ventriculomegaly
title Reliability and interobserver variability of a grading system of ventricular distension in dogs
title_full Reliability and interobserver variability of a grading system of ventricular distension in dogs
title_fullStr Reliability and interobserver variability of a grading system of ventricular distension in dogs
title_full_unstemmed Reliability and interobserver variability of a grading system of ventricular distension in dogs
title_short Reliability and interobserver variability of a grading system of ventricular distension in dogs
title_sort reliability and interobserver variability of a grading system of ventricular distension in dogs
topic canine hydrocephalus
magnetic resonance imaging
VPS
grading system
ventriculomegaly
url https://www.frontiersin.org/articles/10.3389/fvets.2023.1271545/full
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