Lei Zhang, Heng Liu, Zhuanqin Ren, Xiaohu Wang, Xiaoli Meng, Xiaocheng Wei, Jian Yang*

Zhang et al. J Clin Transl Res 2022; 8(6):13

Published online: November 15, 2022


Background: The subarachnoid space width (SASw) is part of crucial neuroimaging criteria for the diagnosis of subarachnoid space enlargement in infants. In addition to indicating the presence of these diseases, SASw can be used to assess their severity. Therefore, it is important to be able to measure the SASw accurately.
Aim: This study aimed to compare the accuracy of measurements made from axial and coronal T2-weighted imaging (T2WI), and to establish a consentaneous measurement scheme of SASw in infants.
Methods: A total of 63 infants (31 males and 32 females) aged 4 days to 24 months were enrolled in this study. The supratentorial subarachnoid space volume (SASv) and corrected SASv (cSASv) were used as the gold standard reference. The SASw (including interhemispheric width and bilateral frontal craniocortical width) was measured on axial and coronal T2WI. The intra- and interobserver reproducibility and agreement of the SASw were assessed by the intraclass correlation coefficient (ICC) and Bland-Altman analysis. A paired t-test was used to compare SASw measured on axial and coronal images. The accuracy of SASw measurements made from axial and coronal T2WI was evaluated by the relationships between the SASw and supratentorial SASv and between the SASw and supratentorial cSASv, and the relationships were examined by multivariate linear regression.
Results: The intra- and interobserver ICC values of the three SASw measurements were greater on coronal T2WI than on axial T2WI. Bland-Altman analysis confirmed that the SASw values measured on coronal T2WI had better intra- and interobserver agreement than axial T2WI. According to the multivariate linear regression results, model 4 (the SASw measured in coronal T2WI) was the best predictor of supratentorial cSASv (R2 = 0.755).
Conclusions: The SASw measured on coronal T2WI was more repeatable and accurate than axial T2WI and was more representative of the actual cerebrospinal fluid accumulation in the supratentorial subarachnoid space.
Relevance for patients: The SASw has been found to be a simple and essential substitution for supratentorial SASv, which can be measured on both axial T2WI passing through the bodies of the bilateral ventricles and coronal T2WI at the level of the foramen of Monro. The SASw measured on coronal T2WI was more beneficial to the diagnosis and severity assessment of subarachnoid space enlargement in infants.


DOI: http://dx.doi.org/10.18053/jctres.08.202206.013

Author affiliation

1. Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710061, Shaanxi, P.R. China.
2. Department of Radiology, Baoji Hi-Tech Hospital, Baoji 721013, Shaanxi, P.R. China.
3. Medical Imaging Center of Guizhou Province, Department of Radiology, the Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou, P.R. China.
4. Department of Radiology, Baoji Center Hospital, Baoji 721008, Shaanxi, P.R. China. 5. Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, P.R. China. 

*Corresponding author
Jian Yang
Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University No. 277 West Yanta Road, Xi’an 710061, Shaanxi, P.R. China.
Tel. +86 189 9123 2396
Fax. 8629-85225009
Email: yj1118@mail.xjtu.edu.cn

Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China


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