ArticleFluids and barriers of the CNS2025
qDESH: a method to quantify disproportionately enlarged subarachnoid space hydrocephalus.
Article in Fluids and barriers of the CNS, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Moving on in hydrocephalus imaging: from 2D to 3D biomarkers.Acta neurochirurgica · 2026Review
- Disproportionately elevated sulcal index (DESI): An automatically driven index representing disproportionate subarachnoid space enlargement in brain MRI scans.Brain research bulletin · 2026Article
- Ventricular volumetry in relation to clinical response and overdrainage after shunt surgery in idiopathic normal-pressure hydrocephalus: a three-year prospective study.Fluids and barriers of the CNS · 2026Article
- Automatic coarse-to-fine AC-PC localization on CT using registration-guided 3D-UNets.Frontiers in neuroinformatics · 2026Article
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11 authors.
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Abstract
background and purposeDisproportionately enlarged subarachnoid space hydrocephalus (DESH) is a radiological biomarker for idiopathic normal pressure hydrocephalus (iNPH). DESH is a subjective measure, based on visual assessments, which may limit its reliability. The aim of this study was to develop and validate a method for the objective quantification of DESH. MATERIALS AND
methodsBy using a semiautomatic quantitative method, we calculated quantitative DESH (qDESH), defined as a ratio between CSF volumes at high convexities and Sylvian fissures. The analysis was based on three-dimensional T1-weighted images from 35 subjects with iNPH (mean age 74 yrs; 10 females) and 45 controls (mean age 72 yrs; 13 females). The interrater agreement for qDESH was evaluated by the intraclass correlation coefficient, and qDESH was compared with visual assessments performed by two neuroradiologists.
resultsAll subjects with iNPH and 13% of the controls visually scored DESH positive. The median qDESH was 2.48 (5th to 95th percentile 0.88 to 5.42) for iNPH and 0.63 (5th to 95th percentile 0.37 to 1.73) for the controls. The area under the receiver operating characteristic curve for qDESH was 0.95 (95% confidence interval 0.90-1) in separating iNPH patients from controls. The interrater agreement for qDESH was 0.99 (95% CI 0.986-0.994, p < 0.001).
conclusionUnlike visual DESH, qDESH generates a continuous variable, enabling reproducible quantification of DESH severity. With this method we can objectively investigate the diagnostic accuracy and prognostic assessment of DESH in iNPH.
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