Stories» Go to news main
Reliability of the Diagnosis of Cerebral Vasospasm Using Catheter Cerebral Angiography: A Systematic Review and Inter‑ and Intraobserver Study
Dr. David Volders has published a paper in the American Journal of Neuroradiology. See full text.
BACKGROUND AND PURPOSE: Conventional angiography is the benchmark examination to diagnose cerebral vasospasm, but there is limited evidence regarding its reliability. Our goals were the following: 1) to systematically review the literature on the reliability of the diagnosis of cerebral vasospasm using conventional angiography, and 2) to perform an agreement study among clinicians who perform endovascular treatment.
MATERIALS AND METHODS: Articles reporting a classification system on the degree of cerebral vasospasm on conventional angiography were systematically searched, and agreement studies were identified. We assembled a portfolio of 221 cases of patients with subarachnoid hemorrhage and asked 17 raters with different backgrounds (radiology, neurosurgery, or neurology) and experience (junior ≤10 and senior >10 years) to independently evaluate cerebral vasospasm in 7 vessel segments using a 3-point scale and to evaluate, for each case, whether findings would justify endovascular treatment. Nine raters took part in the intraobserver reliability study.
RESULTS: The systematic review showed a very heterogeneous literature, with 140 studies using 60 different nomenclatures and 21 different thresholds to define cerebral vasospasm, and 5 interobserver studies reporting a wide range of reliability (κ = 0.14–0.87). In our study, only senior raters reached substantial agreement (κ ≥ 0.6) on vasospasm of the supraclinoid ICA, M1, and basilar segments and only when assessments were dichotomized (presence or absence of ≥50% narrowing). Agreement on whether to proceed with endovascular management of vasospasm was only fair (κ ≤ 0.4).
CONCLUSIONS: Research on cerebral vasospasm would benefit from standardization of definitions and thresholds. Dichotomized decisions by experienced readers are required for the reliable angiographic diagnosis of cerebral vasospasm.
Disclosures: Anne-Christine Januel—UNRELATED: Consultancy: Congress reporting for Balt. Jean-Christophe Gentric—UNRELATED: Consultancy: Balt, Medtronic, MicroVention, Stryker; Stock/Stock Options: INTRADYS.
- Post‑administration dosimetry in yttrium‑90 radioembolization through micro‑CT imaging of radiopaque microspheres in a porcine renal model
- Canadian Society of Thoracic Radiology/Canadian Association of Radiologists Best Practice Guidance for Investigation of Acute Pulmonary Embolism, Part 1: Acquisition and Safety Considerations
- Optimal Transport Scenario for Access to Endovascular Therapy With Consideration of Patient Outcomes and Cost
- Dalhousie Radiology outperforms again at the Canadian Association of Radiologists Annual Meeting
- Angiographic results of surgical or endovascular treatment of intracranial aneurysms: a systematic review and inter‑observer reliability study
- The Many Care Models to Treat Thoracic Aortic Disease in Canada – A Nationwide Survey of Cardiac Surgeons, Cardiologists, Interventional Radiologists and Vascular Surgeons
- Reliability of the Diagnosis of Cerebral Vasospasm Using Catheter Cerebral Angiography: A Systematic Review and Inter‑ and Intraobserver Study
- Magnetic Resonance Imaging Based Radiomic Models of Prostate Cancer: A Narrative Review
comments powered by Disqus