Diagnostic Accuracy and Reliability of Noncontrast Computed Tomography Markers for Acute Hematoma Expansion among Radiologists

被引：5

作者：

Almubarak, Hawra ^{[1
,2
,3
]}

Elsayed, Sarah ^{[4
]}

Mazzacane, Federico ^{[5
,6
]}

Schlunk, Frieder ^{[2
,3
,7
,8
]}

Cao, Haoyin ^{[1
,2
,3
]}

Vu, Ly Huong ^{[1
,2
,3
]}

Vogt, Estelle ^{[1
,2
,3
]}

Orco, Andrea Dell ^{[2
,3
,7
]}

Desser, Dmitriy ^{[2
,3
,7
]}

Boehmer, Maik F. H. ^{[9
]}

Akkurt, Burak Han ^{[9
]}

Sporns, Peter B. ^{[10
]}

Penzkofer, Tobias ^{[8
,11
,12
,13
]}

Hanning, Uta ^{[4
]}

Morotti, Andrea ^{[14
]}

Nawabi, Jawed ^{[1
,2
,3
,8
]}

机构：

[1] Charite Univ Med Berlin, Berlin Inst Hlth, Dept Radiol CCM, Campus Mitte, D-10117 Berlin, Germany

[2] Humboldt Univ, D-10117 Berlin, Germany

[3] Free Univ Berlin, D-10117 Berlin, Germany

[4] Univ Med Ctr Hamburg Eppendorf, Dept Diagnost & Intervent Neuroradiol, D-20251 Hamburg, Germany

[5] Univ Pavia, Dept Brain & Behav Sci, I-27100 Pavia, Italy

[6] IRCCS Fdn Mondino, Malattie Cerebrovasc & Stroke Unit, I-27100 Pavia, Italy

[7] Charite Univ Med Berlin, Berlin Inst Hlth, Dept Neuroradiol CCM, Campus Mitte, D-10117 Berlin, Germany

[8] BIH Biomed Innovat Acad, Berlin Inst Hlth BIH, D-10117 Berlin, Germany

[9] Univ Hosp Muenster, Dept Radiol, D-48149 Munster, Germany

[10] Univ Hosp Basel, Dept Neuroradiol, Clin Radiol & Nucl Med, CH-4031 Basel, Switzerland

[11] Charite Univ Med Berlin, Berlin Inst Hlth, Dept Radiol CCM, Campus Virchow Klinikum, D-13353 Berlin, Germany

[12] Humboldt Univ, D-13353 Berlin, Germany

[13] Free Univ Berlin, D-13353 Berlin, Germany

[14] ASST Spedali Civili, Neurol Unit, Dept Neurol Sci & Vis, I-25123 Brescia, Italy

来源：

TOMOGRAPHY | 2022年 / 8卷 / 06期

关键词：

intracerebral hemorrhage; NCCT marker; reliability; level of experience; INTRACEREBRAL HEMORRHAGE EXPANSION; BLACK-HOLE SIGN; BLEND SIGN; SPOT SIGN; PREDICTORS; GROWTH;

D O I：

10.3390/tomography8060242

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Background: Noncontrast Computed Tomography (NCCT) features are promising markers for acute hematoma expansion (HE) in patients with intracerebral hemorrhage (ICH). It remains unclear whether accurate identification of these markers is also reliable in raters with different levels of experience. Methods: Patients with acute spontaneous ICH admitted at four tertiary centers in Germany and Italy were retrospectively included from January 2017 to June 2020. In total, nine NCCT markers were rated by one radiology resident, one radiology fellow, and one neuroradiology fellow with different levels experience in ICH imaging. Interrater reliabilities of the resident and radiology fellow were evaluated by calculated Cohen's kappa (kappa) statistics in reference to the neuroradiology fellow who was referred as the gold standard. Gold-standard ratings were evaluated by calculated interrater kappa statistics. Global interrater reliabilities were evaluated by calculated Fleiss kappa statistics across all three readers. A comparison of receiver operating characteristics (ROCs) was used to evaluate differences in the diagnostic accuracy for predicting acute hematoma expansion (HE) among the raters. Results: Substantial-to-almost-perfect interrater concordance was found for the resident with interrater Cohen's kappa from 0.70 (95% CI 0.65-0.81) to 0.96 (95% CI 0.94-0.98). The interrater Cohen's kappa for the radiology fellow was moderate to almost perfect and ranged from 0.58 (95% CI 0.52-0.65) to 94 (95% CI 92-0.97). The intrarater gold-standard Cohen's kappa was almost perfect and ranged from 0.79 (95% CI 0.78-0.90) to 0.98 (95% CI 0.78-0.90). The global interrater Fleiss kappa ranged from 0.62 (95%CI 0.57-0.66) to 0.93 (95%CI 0.89-0.97). The diagnostic accuracy for the prediction of acute hematoma expansion (HE) was different for the island sign and fluid sign, with p-values < 0.05. Conclusion: The NCCT markers had a substantial-to-almost-perfect interrater agreement among raters with different levels of experience. Differences in the diagnostic accuracy for the prediction of acute HE were found in two out of nine NCCT markers. The study highlights the promising utility of NCCT markers for acute HE prediction.

引用

页码：2893 / 2901

页数：9

共 27 条

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