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on idiopathic normal pressure hydrocephalus (iNPH) imaging markers and their normal values are scarce. This population-based study aimed to analyze several morphologic and volumetric iNPH-related imaging markers in a large sample, determining their distribution, diagnostic accuracy, suggested cut-offs, and associations with iNPH symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study included 791 70 year olds, 40 with radiologically probable iNPH (iNPH\n                      <jats:sub>Radiol<\/jats:sub>\n                      ) and 751 without iNPH features (reference). MRI measures included Evans index (EI), z-EI, brain per ventricle ratio at anterior (BVR\n                      <jats:sub>AC<\/jats:sub>\n                      ) and posterior commissures (BVR\n                      <jats:sub>PC<\/jats:sub>\n                      ), sulcal compression, Sylvian fissure enlargement, callosal angle, diameter of temporal horns, 3\n                      <jats:sup>rd<\/jats:sup>\n                      and 4\n                      <jats:sup>th<\/jats:sup>\n                      ventricles, midbrain, and pons. Volumes of ventricles, corpus callosum, and brainstem were computed using automated segmentation. ROC analysis determined imaging markers\u2019 cut-offs. Symptoms were evaluated clinically and through self-report.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the reference group, median values (95% CI) for imaging markers were as follows: EI: 0.27 (0.26\u20130.27), z-EI: 0.28 (0.26\u20130.31), BVR\n                      <jats:sub>AC<\/jats:sub>\n                      : 1.69 (1.48\u20131.90), and BVR\n                      <jats:sub>PC<\/jats:sub>\n                      : 2.66 (2.24\u20133.27). Most imaging markers differed significantly between iNPH\n                      <jats:sub>Radiol<\/jats:sub>\n                      and the reference. Lateral ventricle volumes correlated better with z-EI and BVR than EI (Rs &gt; 0.81 vs 0.68). Optimal cut-off values for z-EI, and BVR\n                      <jats:sub>AC<\/jats:sub>\n                      and BVR\n                      <jats:sub>PC<\/jats:sub>\n                      for distinguishing iNPH\n                      <jats:sub>Radiol<\/jats:sub>\n                      were 0.32, 1.36, and 1.83, respectively. Clinical symptoms correlated moderately with imaging markers (Rs &lt; 0.49 for iNPH\n                      <jats:sub>Radiol<\/jats:sub>\n                      ,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We report population-based reference values and propose cut-offs for iNPH-related imaging markers and volumetric measurements. Z-EI and BVR are likely superior markers for assessing ventricular enlargement in iNPH. Imaging markers of iNPH correlate moderately with iNPH symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19714009241303132","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T05:37:26Z","timestamp":1733722646000},"page":"475-487","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["MRI markers of idiopathic normal pressure hydrocephalus in a population study with 791 participants: Exploring reference values and associations"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1830-1699","authenticated-orcid":false,"given":"Clara","family":"Constantinescu","sequence":"first","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doerthe","family":"Ziegelitz","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Wikkels\u00f8","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Kern","sequence":"additional","affiliation":[{"name":"Sahlgrenska University Hospital"},{"name":"Center for Ageing and Health (AGECAP) at the University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Jaraj","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Ryd\u00e9n","sequence":"additional","affiliation":[{"name":"Center for Ageing and Health (AGECAP) at the University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Westman","sequence":"additional","affiliation":[{"name":"Karolinska Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingmar","family":"Skoog","sequence":"additional","affiliation":[{"name":"Center for Ageing and Health (AGECAP) at the University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Tullberg","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,9]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2012.01676.x"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000342"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2014.01.033"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000208037"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.st.2020-0292"},{"issue":"3","key":"e_1_3_4_7_2","first-page":"S4","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin N","year":"2005","unstructured":"Relkin N, Marmarou A, Klinge P, et al. 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