Reliability of a novel, semi‐quantitative scale for classification of structural brain magnetic resonance imaging in children with cerebral palsy

• DOI: 10.1111/dmcn.12457
• Publication Date: 2014-04-19T11:18:59Z
• Authors: Simona Fiori; Giovanni Cioni; Katrjin Klingels; Els Ortibus; Leen Van Gestel; Stephen Rose; Roslyn N Boyd; Hilde Feys; Andrea Guzzetta
• Keywords: Male; Adolescent; 610; Severity of Illness Index; 618; 2806 Developmental Neuroscience; 03 medical and health sciences; Magnetic resonance imaging; 0302 clinical medicine; Humans; Child; Children; Cerebral Palsy; Brain; Reproducibility of Results; Perinatology; Magnetic Resonance Imaging; 3. Good health; and Child Health; Adolescent, Brain; pathology, Cerebral Palsy; diagnosis/pathology, Child, Child; Preschool, Female, Humans, Magnetic Resonance Imaging, Male, Reproducibility of Results, Severity of Illness Index; Child, Preschool; Cerebral palsy; Female; 2735 Pediatrics; 2728 Clinical Neurology

AimTo describe the development of a novel rating scale for classification of brain structural magnetic resonance imaging (MRI) in children with cerebral palsy (CP) and to assess its interrater and intrarater reliability.MethodThe scale consists of three sections. Section 1 contains descriptive information about the patient and MRI. Section 2 contains the graphical template of brain hemispheres onto which the lesion is transposed. Section 3 contains the scoring system for the quantitative analysis of the lesion characteristics, grouped into different global scores and subscores that assess separately side, regions, and depth. A larger interrater and intrarater reliability study was performed in 34 children with CP (22 males, 12 females; mean age at scan of 9y 5mo [SD 3y 3mo], range 4y–16y 11mo; Gross Motor Function Classification System level I, [n=22], II [n=10], and level III [n=2]).ResultsVery high interrater and intrarater reliability of the total score was found with indices above 0.87. Reliability coefficients of the lobar and hemispheric subscores ranged between 0.53 and 0.95. Global scores for hemispheres, basal ganglia, brain stem, and corpus callosum showed reliability coefficients above 0.65.InterpretationThis study presents the first visual, semi‐quantitative scale for classification of brain structural MRI in children with CP. The high degree of reliability of the scale supports its potential application for investigating the relationship between brain structure and function and examining treatment response according to brain lesion severity in children with CP.