Abstract：
BACKGROUND: This cross-sectional study aimed to report all neuroimaging findings suggestive of raised intracranial pressure in children with pseudotumor cerebri syndrome (PTCS), before and after re-review by two neuroradiologists.
METHODS: We included 48 children aged <18 years diagnosed with PTCS between 2016 and 2021. Clinical and radiological data were obtained from their medical files. Two neuroradiologists independently re-reviewed all neuroimages, and the average of their assessments was compared with the initial neuroimaging reports; an additional review was done to analyze inter- and intraclass correlation.
RESULTS: The initial neuroimaging reports showed under-reporting of findings, with only 26 of 48 (54.1%) patients identified with abnormal reports. After revision, the proportion of the reported findings increased to 44 of 48 (91.6%). Distention of the perioptic space was the most commonly reported finding after revision (36.5 of 48; 76%). Flattening of the posterior globe and empty sella were initially under-reported but improved after revision. Moreover, several findings suggestive of increased intracranial pressure not mandated by Friedman criteria were identified, such as narrowing of the Meckel cave, posterior displacement of the pituitary stalk, and narrowing of the cavernous sinus. Analysis of associations between neuroimaging findings and demographic and clinical characteristics yielded no statistically significant results. The inter- and intraclass correlation results demonstrated a significant agreement between raters and within each rater\'s assessment (P < 0.05).
CONCLUSIONS: This study highlights the impact of image revision in enhancing PTCS diagnosis. Intra- and interclass correlations underscore the reliability of the review process, emphasizing the importance of meticulous image analysis in clinical practice.
METHODS: We included 48 children aged <18 years diagnosed with PTCS between 2016 and 2021. Clinical and radiological data were obtained from their medical files. Two neuroradiologists independently re-reviewed all neuroimages, and the average of their assessments was compared with the initial neuroimaging reports; an additional review was done to analyze inter- and intraclass correlation.
RESULTS: The initial neuroimaging reports showed under-reporting of findings, with only 26 of 48 (54.1%) patients identified with abnormal reports. After revision, the proportion of the reported findings increased to 44 of 48 (91.6%). Distention of the perioptic space was the most commonly reported finding after revision (36.5 of 48; 76%). Flattening of the posterior globe and empty sella were initially under-reported but improved after revision. Moreover, several findings suggestive of increased intracranial pressure not mandated by Friedman criteria were identified, such as narrowing of the Meckel cave, posterior displacement of the pituitary stalk, and narrowing of the cavernous sinus. Analysis of associations between neuroimaging findings and demographic and clinical characteristics yielded no statistically significant results. The inter- and intraclass correlation results demonstrated a significant agreement between raters and within each rater\'s assessment (P < 0.05).
CONCLUSIONS: This study highlights the impact of image revision in enhancing PTCS diagnosis. Intra- and interclass correlations underscore the reliability of the review process, emphasizing the importance of meticulous image analysis in clinical practice.
摘要：
背景：这项横断面研究旨在报告所有提示假瘤脑综合征（PTCS）儿童颅内压升高的神经影像学发现，之前和之后由两名神经放射学家重新审查。
方法：我们纳入了2016年至2021年诊断为PTCS的48名年龄<18岁的儿童。临床和放射学数据是从他们的医学档案中获得的。两名神经放射科医生独立地重新检查了所有的神经影像,并将他们的评估平均值与最初的神经影像学报告进行了比较;我们还进行了一项审查,以分析组间和组内的相关性.
结果：最初的神经影像学报告显示发现报告不足，48例患者中只有26例（54.1%）发现有异常报告。修订后,报告发现的比例增加到48个中的44个(91.6%).视周空间的扩张是翻修后最常见的发现（48个中的36.5个；76％）。最初报道不足后眼球和空蝶鞍的扁平化，但经过修正后有所改善。此外，发现了一些提示Friedman标准未规定颅内压升高的发现,比如Meckel洞穴的狭窄,垂体柄的后移,海绵窦变窄.神经影像学检查结果与人口统计学和临床特征之间的关联分析没有产生统计学意义的结果。组间和组内的相关性结果表明，评估者之间以及每个评估者的评估结果之间存在显着一致性（P<0.05）。
结论：本研究强调了图像翻修对增强PTCS诊断的影响。类内和类间的相关性强调了审查过程的可靠性，强调细致的图像分析在临床实践中的重要性。
方法：我们纳入了2016年至2021年诊断为PTCS的48名年龄<18岁的儿童。临床和放射学数据是从他们的医学档案中获得的。两名神经放射科医生独立地重新检查了所有的神经影像,并将他们的评估平均值与最初的神经影像学报告进行了比较;我们还进行了一项审查,以分析组间和组内的相关性.
结果：最初的神经影像学报告显示发现报告不足，48例患者中只有26例（54.1%）发现有异常报告。修订后,报告发现的比例增加到48个中的44个(91.6%).视周空间的扩张是翻修后最常见的发现（48个中的36.5个；76％）。最初报道不足后眼球和空蝶鞍的扁平化，但经过修正后有所改善。此外，发现了一些提示Friedman标准未规定颅内压升高的发现,比如Meckel洞穴的狭窄,垂体柄的后移,海绵窦变窄.神经影像学检查结果与人口统计学和临床特征之间的关联分析没有产生统计学意义的结果。组间和组内的相关性结果表明，评估者之间以及每个评估者的评估结果之间存在显着一致性（P<0.05）。
结论：本研究强调了图像翻修对增强PTCS诊断的影响。类内和类间的相关性强调了审查过程的可靠性，强调细致的图像分析在临床实践中的重要性。
