RT Journal Article
SR Electronic
T1 Noninvasive Angiographic Results of Clipped or Coiled Intracranial Aneurysms: An Inter- and Intraobserver Reliability Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1615
OP 1620
DO 10.3174/ajnr.A7236
VO 42
IS 9
A1 Benomar, A.
A1 Farzin, B.
A1 Gevry, G.
A1 Boisseau, W.
A1 Roy, D.
A1 Weill, A.
A1 Iancu, D.
A1 Guilbert, F.
A1 Létourneau-Guillon, L.
A1 Jacquin, G.
A1 Chaalala, C.
A1 Bojanowski, M.W.
A1 Labidi, M.
A1 Fahed, R.
A1 Volders, D.
A1 Nguyen, T.N.
A1 Gentric, J.-C.
A1 Magro, E.
A1 Boulouis, G.
A1 Forestier, G.
A1 Hak, J.-F.
A1 Ghostine, J.S.
A1 Kaderali, Z.
A1 Shankar, J.J.
A1 Kotowski, M.
A1 Darsaut, T.E.
A1 Raymond, J.
YR 2021
UL http://www.ajnr.org/content/42/9/1615.abstract
AB BACKGROUND AND PURPOSE: Noninvasive angiography is commonly used to assess the outcome of surgical or endovascular treatment of intracranial aneurysms in clinical series or randomized trials. We sought to assess whether a standardized 3-grade classification system could be reliably used to compare the CTA and MRA results of both treatments.MATERIALS AND METHODS: An electronic portfolio composed of CTAs of 30 clipped and MRAs of 30 coiled aneurysms was independently evaluated by 24 raters of diverse experience and training backgrounds. Twenty raters performed a second evaluation 1 month later. Raters were asked which angiographic grade and management decision (retreatment; close or long-term follow-up) would be most appropriate for each case. Agreement was analyzed using the Krippendorff α (αK) statistic, and the relationship between angiographic grade and clinical management choice, using the Fisher exact and Cramer V tests.RESULTS: Interrater agreement was substantial (αK = 0.63; 95% CI, 0.55–0.70); results were slightly better for MRA results of coiling (αK = 0.69; 95% CI, 0.56–0.76) than for CTA results of clipping (αK = 0.58; 95% CI, 0.44–0.69). Intrarater agreement was substantial to almost perfect. Interrater agreement regarding clinical management was moderate for both clipped (αK = 0.49; 95% CI, 0.32–0.61) and coiled subgroups (αK = 0.47; 95% CI, 0.34–0.54). The choice of clinical management was strongly associated with the size of the residuum (mean Cramer V = 0.77 [SD, 0.14]), but complete occlusions (grade 1) were followed more closely after coiling than after clipping (P = .01).CONCLUSIONS: A standardized 3-grade scale was found to be a reliable and clinically meaningful tool to compare the results of clipping and coiling of aneurysms using CTA or MRA.αKKrippendorff α