D Iancu-Gontard1, A Weill, F Guilbert, T Nguyen, J Raymond, D Roy. 1. Department of Radiology, Interventional Neuroradiology Section, Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, PQ, Canada.
Abstract
BACKGROUND AND PURPOSE: Several angiographic features of brain arteriovenous malformations (BAVMs) have been associated with an increased risk of hemorrhage. However, interpretation of these features may not be consistent between observers. We conducted a study to determine inter- and intraobserver agreement of various angioarchitectural characteristics of BAVM. MATERIALS AND METHODS: Two experienced interventional neuroradiologists independently reviewed pre- and post-endovascular treatment angiograms from 50 consecutive patients. Axial CT and/or MR images before treatment were included. We collected the following data: Spetzler-Martin grades, number of involved arterial territories, associated aneurysms by location (circle of Willis, feeding artery, intranidal, and venous), and nidus reduction after endovascular treatment (<33%, 33%-66%, and >66%). The reviewers were compared with each other, and 1 was compared with himself after a 3-month interval. Measures of agreement were performed by using the kappa statistic (kappa) for nominal data and the weighted kappa for ordinal data. RESULTS: Inter- and intraobserver agreement were higher for assessment of the Spetzler-Martin grade (weighted kappa = 0.70/0.75) and nidus size reduction after endovascular treatment (kappa = 0.74/0.77). Inter- and intraobserver agreement were inferior for findings concerning feeding artery aneurysms (kappa = 0.19/0.36), intranidal aneurysms (kappa = 0.34/0.35), and venous aneurysms (kappa = 0.50/0.67). CONCLUSION: Angiographic characteristics of BAVMs considered as risk factors for hemorrhage, such as aneurysms, are not reliably detected on global angiograms between different observers. In contrast, the Spetzler-Martin grading system and angiographic results of endovascular treatment can be used with high observer agreement.
BACKGROUND AND PURPOSE: Several angiographic features of brain arteriovenous malformations (BAVMs) have been associated with an increased risk of hemorrhage. However, interpretation of these features may not be consistent between observers. We conducted a study to determine inter- and intraobserver agreement of various angioarchitectural characteristics of BAVM. MATERIALS AND METHODS: Two experienced interventional neuroradiologists independently reviewed pre- and post-endovascular treatment angiograms from 50 consecutive patients. Axial CT and/or MR images before treatment were included. We collected the following data: Spetzler-Martin grades, number of involved arterial territories, associated aneurysms by location (circle of Willis, feeding artery, intranidal, and venous), and nidus reduction after endovascular treatment (<33%, 33%-66%, and >66%). The reviewers were compared with each other, and 1 was compared with himself after a 3-month interval. Measures of agreement were performed by using the kappa statistic (kappa) for nominal data and the weighted kappa for ordinal data. RESULTS: Inter- and intraobserver agreement were higher for assessment of the Spetzler-Martin grade (weighted kappa = 0.70/0.75) and nidus size reduction after endovascular treatment (kappa = 0.74/0.77). Inter- and intraobserver agreement were inferior for findings concerning feeding artery aneurysms (kappa = 0.19/0.36), intranidal aneurysms (kappa = 0.34/0.35), and venous aneurysms (kappa = 0.50/0.67). CONCLUSION: Angiographic characteristics of BAVMs considered as risk factors for hemorrhage, such as aneurysms, are not reliably detected on global angiograms between different observers. In contrast, the Spetzler-Martin grading system and angiographic results of endovascular treatment can be used with high observer agreement.
Authors: R P Atkinson; I A Awad; H H Batjer; C F Dowd; A Furlan; S L Giannotta; C R Gomez; D Gress; G Hademenos; V Halbach; J C Hemphill; R T Higashida; L N Hopkins; M B Horowitz; S C Johnston; M W Lawton; M W McDermott; A M Malek; J P Mohr; A I Qureshi; H Riina; W S Smith; J Pile-Spellman; R F Spetzler; T A Tomsick; W L Young Journal: Stroke Date: 2001-06 Impact factor: 7.914
Authors: Marco A Stefani; Phillip J Porter; Karel G terBrugge; Walter Montanera; Robert A Willinsky; M Christopher Wallace Journal: Stroke Date: 2002-04 Impact factor: 7.914
Authors: Eui Jong Kim; Alexander X Halim; Christopher F Dowd; Michael T Lawton; Vineeta Singh; John Bennett; William L Young Journal: Neurosurgery Date: 2004-06 Impact factor: 4.654
Authors: K H Narsinh; K Mueller; J Nelson; J Massachi; D C Murph; A Z Copelan; S W Hetts; V V Halbach; R T Higashida; A A Abla; M R Amans; C F Dowd; H Kim; D L Cooke Journal: AJNR Am J Neuroradiol Date: 2020-10-29 Impact factor: 3.825