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Neuropediatrics 2014; 45(02): 084-092
DOI: 10.1055/s-0033-1357480
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Reliability of Fractional Anisotropy Measurement for Children with Cerebral Palsy

Kyunghoon Min
1   Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
,
Su Jin Yu
1   Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
,
Ji Hyun Lee
1   Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
,
Junyoung Song
1   Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
,
Jae Sun Shim
1   Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
,
Hee Song Lee
1   Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
,
Sang Heum Kim
2   Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
,
MinYoung Kim
1   Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
› Author Affiliations
Further Information

Publication History

03 May 2013

26 July 2013

Publication Date:
13 October 2013 (online)

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Abstract

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.

Keywords

fractional anisotropy - reliability - cerebral palsy - periventricular leukomalacia
 

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