Visual assessment of medial temporal atrophy on MR films in Alzheimer's disease: comparison with volumetry

Aging Clin Exp Res. 2005 Feb;17(1):8-13. doi: 10.1007/BF03337714.


Background and aims: To test the agreement of a visual rating scale of medial temporal lobe atrophy (MTA) with linear and volumetric assessments, and to test its accuracy in discriminating between Alzheimer's disease (AD) patients and controls.

Methods: Participants were 28 patients with AD and 29 healthy controls. MTA was evaluated according to Scheltens' five-point scale. Its accuracy in distinguishing AD patients from controls was evaluated as a stand-alone measure and in association with linear [width of the temporal horn (WTH)] and volumetric [hippocampal volume (HV)] measures.

Results: The agreement of this visual rating scale with the other MTA measures was statistically significant (vs WTH and vs HV, p for trend < 0.00005). The visual rating scale showed a good accuracy in distinguishing AD patients from controls [area under the curve (AUC) 0.89, 95% confidence interval (CI) 0.79-0.98]. Although the accuracy of the visual rating scale improved in association with linear WTH (AUC 0.91, 95% CI 0.82-0.99) and in association with HV (AUC 0.93, 95% CI 0.86-1.00), the improvement was not significant.

Conclusions: The visual rating scale of MTA, easily applicable in clinical practice, shows good agreement with more demanding quantitative methods, and can discriminate AD patients from controls with good accuracy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Area Under Curve
  • Atrophy
  • Diagnosis, Computer-Assisted* / standards
  • Female
  • Hippocampus / pathology
  • Humans
  • Magnetic Resonance Imaging* / standards
  • Male
  • Middle Aged
  • ROC Curve
  • Single-Blind Method
  • Temporal Lobe / pathology*