Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.

<h4>Background and purpose</h4>Good reliability of methods to assess the extent of ischemia in acute stroke is important for implementation in clinical practice, especially between observers with varying experience. Our aim was to determine inter- and intra-observer reliability of the 1/...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Tom van Seeters, Geert Jan Biessels, Joris M Niesten, Irene C van der Schaaf, Jan Willem Dankbaar, Alexander D Horsch, Willem P T M Mali, L Jaap Kappelle, Yolanda van der Graaf, Birgitta K Velthuis, Dust Investigators
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2013
Materias:
R
Q
Acceso en línea:https://doaj.org/article/7fa85162d0c240caaaf73e2f4aade877
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:7fa85162d0c240caaaf73e2f4aade877
record_format dspace
spelling oai:doaj.org-article:7fa85162d0c240caaaf73e2f4aade8772021-11-18T08:51:58ZReliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.1932-620310.1371/journal.pone.0075615https://doaj.org/article/7fa85162d0c240caaaf73e2f4aade8772013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24116061/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and purpose</h4>Good reliability of methods to assess the extent of ischemia in acute stroke is important for implementation in clinical practice, especially between observers with varying experience. Our aim was to determine inter- and intra-observer reliability of the 1/3 middle cerebral artery (MCA) rule and the Alberta Stroke Program Early CT Score (ASPECTS) for different CT modalities in patients suspected of acute ischemic stroke.<h4>Methods</h4>We prospectively included 105 patients with acute neurological deficit due to suspected acute ischemic stroke within 9 hours after symptom onset. All patients underwent non-contrast CT, CT perfusion and CT angiography on admission. All images were evaluated twice for presence of ischemia, ischemia with >1/3 MCA involvement, and ASPECTS. Four observers evaluated twenty scans twice for intra-observer agreement. We used kappa statistics and intraclass correlation coefficient to calculate agreement.<h4>Results</h4>Inter-observer agreement for the 1/3 MCA rule and ASPECTS was fair to good for non-contrast CT, poor to good for CT angiography source images, but excellent for all CT perfusion maps (cerebral blood volume, mean transit time, and predicted penumbra and infarct maps). Intra-observer agreement for the 1/3 MCA rule and ASPECTS was poor to good for non-contrast CT, fair to moderate for CT angiography source images, and good to excellent for all CT perfusion maps.<h4>Conclusion</h4>Between observers with a different level of experience, agreement on the radiological diagnosis of cerebral ischemia is much better for CT perfusion than for non-contrast CT and CT angiography source images, and therefore CT perfusion is a very reliable addition to standard stroke imaging.Tom van SeetersGeert Jan BiesselsJoris M NiestenIrene C van der SchaafJan Willem DankbaarAlexander D HorschWillem P T M MaliL Jaap KappelleYolanda van der GraafBirgitta K VelthuisDust InvestigatorsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 10, p e75615 (2013)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Tom van Seeters
Geert Jan Biessels
Joris M Niesten
Irene C van der Schaaf
Jan Willem Dankbaar
Alexander D Horsch
Willem P T M Mali
L Jaap Kappelle
Yolanda van der Graaf
Birgitta K Velthuis
Dust Investigators
Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.
description <h4>Background and purpose</h4>Good reliability of methods to assess the extent of ischemia in acute stroke is important for implementation in clinical practice, especially between observers with varying experience. Our aim was to determine inter- and intra-observer reliability of the 1/3 middle cerebral artery (MCA) rule and the Alberta Stroke Program Early CT Score (ASPECTS) for different CT modalities in patients suspected of acute ischemic stroke.<h4>Methods</h4>We prospectively included 105 patients with acute neurological deficit due to suspected acute ischemic stroke within 9 hours after symptom onset. All patients underwent non-contrast CT, CT perfusion and CT angiography on admission. All images were evaluated twice for presence of ischemia, ischemia with >1/3 MCA involvement, and ASPECTS. Four observers evaluated twenty scans twice for intra-observer agreement. We used kappa statistics and intraclass correlation coefficient to calculate agreement.<h4>Results</h4>Inter-observer agreement for the 1/3 MCA rule and ASPECTS was fair to good for non-contrast CT, poor to good for CT angiography source images, but excellent for all CT perfusion maps (cerebral blood volume, mean transit time, and predicted penumbra and infarct maps). Intra-observer agreement for the 1/3 MCA rule and ASPECTS was poor to good for non-contrast CT, fair to moderate for CT angiography source images, and good to excellent for all CT perfusion maps.<h4>Conclusion</h4>Between observers with a different level of experience, agreement on the radiological diagnosis of cerebral ischemia is much better for CT perfusion than for non-contrast CT and CT angiography source images, and therefore CT perfusion is a very reliable addition to standard stroke imaging.
format article
author Tom van Seeters
Geert Jan Biessels
Joris M Niesten
Irene C van der Schaaf
Jan Willem Dankbaar
Alexander D Horsch
Willem P T M Mali
L Jaap Kappelle
Yolanda van der Graaf
Birgitta K Velthuis
Dust Investigators
author_facet Tom van Seeters
Geert Jan Biessels
Joris M Niesten
Irene C van der Schaaf
Jan Willem Dankbaar
Alexander D Horsch
Willem P T M Mali
L Jaap Kappelle
Yolanda van der Graaf
Birgitta K Velthuis
Dust Investigators
author_sort Tom van Seeters
title Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.
title_short Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.
title_full Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.
title_fullStr Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.
title_full_unstemmed Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke.
title_sort reliability of visual assessment of non-contrast ct, ct angiography source images and ct perfusion in patients with suspected ischemic stroke.
publisher Public Library of Science (PLoS)
publishDate 2013
url https://doaj.org/article/7fa85162d0c240caaaf73e2f4aade877
work_keys_str_mv AT tomvanseeters reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT geertjanbiessels reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT jorismniesten reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT irenecvanderschaaf reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT janwillemdankbaar reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT alexanderdhorsch reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT willemptmmali reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT ljaapkappelle reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT yolandavandergraaf reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT birgittakvelthuis reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
AT dustinvestigators reliabilityofvisualassessmentofnoncontrastctctangiographysourceimagesandctperfusioninpatientswithsuspectedischemicstroke
_version_ 1718421212224290816