Pacheco Felipe Torres, Rocha Antônio José da, Littig Ingrid Aguiar, Júnior Antonio Carlos Martins Maia, Gagliardi Rubens José
Division of Neuroradiology, Santa Casa de Misericórdia de São Paulo, São PauloSP, Brazil.
Arq Neuropsiquiatr. 2013 Jun;71(6):349-56. doi: 10.1590/0004-282X20130037.
Multidetector computed tomography (MDCT) scanning has enabled the early diagnosis of hyperacute brain ischemia. We aimed at validating a standardized protocol to read and report MDCT techniques in a series of adult patients. The inter-observer agreement among the trained examiners was tested, and their results were compared with a standard reading. No false positives were observed, and an almost perfect agreement (Kappa>0.81) was documented when the CT angiography (CTA) and cerebral perfusion CT (CPCT) map data were added to the noncontrast CT (NCCT) analysis. The inter-observer agreement was higher for highly trained readers, corroborating the need for specific training to interpret these modern techniques. The authors recommend adding CTA and CPCT to the NCCT analysis in order to clarify the global analysis of structural and hemodynamic brain abnormalities. Our structured report is suitable as a script for the reproducible analysis of the MDCT of patients on suspicion of ischemic stroke.
多排螺旋计算机断层扫描（MDCT）已能够实现超急性脑缺血的早期诊断。我们旨在验证一种标准化方案，用于对一系列成年患者的MDCT技术进行解读和报告。我们测试了经过培训的检查人员之间的观察者间一致性，并将他们的结果与标准解读进行比较。未观察到假阳性结果，当将CT血管造影（CTA）和脑灌注CT（CPCT）图谱数据添加到非增强CT（NCCT）分析中时，记录到几乎完美的一致性（kappa>0.81）。对于训练有素的读者，观察者间一致性更高，这证实了对解读这些现代技术进行专项培训的必要性。作者建议将CTA和CPCT添加到NCCT分析中，以明确对脑结构和血流动力学异常的整体分析。我们的结构化报告适合作为对疑似缺血性卒中患者进行MDCT可重复性分析的脚本。
