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

Adriana Czerwik; Martin Jürgen Schmidt; Agnieszka Olszewska; Steven Hinz; Kathrin Büttner; Daniela Farke

doi:10.3389/fvets.2023.1271545

Frontiers in Veterinary Science (Nov 2023)

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

Adriana Czerwik,
Martin Jürgen Schmidt,
Agnieszka Olszewska,
Steven Hinz,
Kathrin Büttner,
Daniela Farke

Affiliations

Adriana Czerwik: Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, Germany
Martin Jürgen Schmidt: Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, Germany
Agnieszka Olszewska: Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, Germany
Steven Hinz: Small Animal Veterinary Practice Westpark, Wettenberg, Germany
Kathrin Büttner: Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany
Daniela Farke: Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University, Giessen, Germany

DOI: https://doi.org/10.3389/fvets.2023.1271545
Journal volume & issue: Vol. 10

Abstract

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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.

Published in Frontiers in Veterinary Science

ISSN: 2297-1769 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Agriculture: Animal culture: Veterinary medicine
Website: https://www.frontiersin.org/journals/veterinary-science

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