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Disproportionately Elevated Sulcal Index (DESI): An automatically driven index representing disproportionate subarachnoid space enlargement in brain MRI scans
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DOI:10.1016/j.brainresbull.2026.111928.png)
Abstract
En 中文
• Fully automated deep-learning based U-Net MRI index quantifies the hallmark CSF redistribution of iNPH from a single T1-weighted scan, eliminating subjective DESH visual rating. The pipeline provides a continuous, rater-independent volumetric metric that eliminates the subjectivity of manual imaging assessments. • Disproportionately Elevated Sulcal Index (DESI) demonstrates high performance and reliability across a large, diverse dataset of over 1,200 scans and was further validated using multi-site external data from the Placebo-Controlled Efficacy in iNPH Shunting trial. • A proportional 30° anterior commissure – posterior commissure wedge intrinsically normalizes for head size, yielding a continuous, intracranial volume-independent metric. • DESI distinguishes NPH from Normal aging and other neurodegenerative diseases with high performance (AUC > 0.94).
Keywords:
Normal Pressure Hydrocephalus (NPH)
Disproportionately Enlarged Subarachnoid-space Hydrocephalus (DESH)
Deep Learning
MRI Biomarker
Dementia
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