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Reliability of the Diagnosis of Cerebral Vasospasm Using Catheter Cerebral Angiography: A Systematic Review and Inter- and Intraobserver Study
- Source :
- AJNR Am J Neuroradiol
- Publication Year :
- 2021
- Publisher :
- American Society of Neuroradiology (ASNR), 2021.
-
Abstract
- 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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Catheters
Subarachnoid hemorrhage
Neurology
Adolescent
MEDLINE
030218 nuclear medicine & medical imaging
Young Adult
03 medical and health sciences
0302 clinical medicine
Cerebral vasospasm
Humans
Vasospasm, Intracranial
Medicine
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Reliability (statistics)
Aged
Observer Variation
Interventional
medicine.diagnostic_test
business.industry
Reproducibility of Results
Vasospasm
Middle Aged
Subarachnoid Hemorrhage
medicine.disease
Cerebral Angiography
cardiovascular system
Female
Neurology (clinical)
Radiology
Neurosurgery
business
030217 neurology & neurosurgery
Cerebral angiography
Subjects
Details
- ISSN :
- 1936959X and 01956108
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- American Journal of Neuroradiology
- Accession number :
- edsair.doi.dedup.....754d620c80bbbabe1594080756f0f1dd