The Boston Criteria v2.0 for cerebral amyloid angiopathy: A multicentre MRI-neuropathology diagnostic accuracy study

作者：A. Charidimou, G. Boulouis, M. Frosch, J. Baron, M. Pasi, J. Albucher, G. Banerjee, Carmen Barbato, F. Bonneville, S. Brandner, L. Calvière, François Caparros, B. Casolla, C. Cordonnier, M. Delisle, V. Deramecourt, M. Dichgans, E. Gokcal, J. Herms, M. Hernández-Guillamon, H. Jäger, Z. Jaunmuktane, J. Linn, S. Martinez-Ramirez, E. Martínez-Sáez, C. Mawrin, J. Montaner, S. Moulin, J. Olivot, F. Piazza, L. Puy, N. Raposo, M. Rodrigues, S. Roeber, J. R. Romero, N. Samarasekera, J. Schneider, S. Schreiber, F. Schreiber, Corentin Schwall, Colin Smith, Levente Szalardy, P. Varlet, A. Viguier, J. Wardlaw, Andrew D. Warren, F. Wollenweber, M. Zedde, M. V. van Buchem, M. Gurol, A. Viswanathan, R. Al-Shahi Salman, E. Smith, D. Werring, S. Greenberg · 发表于：Lancet Neurology · 年份：2022 · DOI：10.1016/s1474-4422(22)00208-3 · 被引用次数：482 · 研究领域：Medicine

Background: The Boston Criteria are used worldwide for in vivo diagnosis of cerebral amyloid angiopathy (CAA) but have not been updated since 2010, prior to emergence of additional MRI markers. Methods: We performed a retrospective analysis of clinical, radiological, and histopathological data available to sites participating in the International CAA Association to formulate and determine the diagnostic accuracy of updated Boston Criteria across different samples and clinical presentations. Ten North American and European academic medical centres identified patients age ≥50 with potential CAA-related clinical presentations (spontaneous intracerebral haemorrhage, cognitive impairment, or transient focal neurological episodes), available brain MRI, and histopathologic assessment for CAA diagnosis. MRIs were centrally rated for haemorrhagic and non-haemorrhagic CAA markers and brain tissue samples rated by neuropathologists at the contributing sites for CAA. We derived Boston criteria v2.0 by selecting MRI features to optimize diagnostic specificity and sensitivity in a prespecified derivation sample (Boston cases 1994–2012, n=159), then externally validated the criteria in prespecified temporal (Boston cases 2012–2018, n=59) and geographical (non-Boston cases 2004–2018; n=123) validation samples, comparing their accuracy to the currently used modified Boston criteria. Findings: The study protocol was finalized 15 January 2017, patient identification completed 31 December 2018, ...