Hijdra A, Brouwers P J, Vermeulen M, van Gijn J
University Department of Neurology, Academisch Medisch Centrum, Amsterdam, The Netherlands.
Stroke. 1990 Aug;21(8):1156-61. doi: 10.1161/01.str.21.8.1156.
According to several studies, the amount of subarachnoid blood on the initial computed tomogram of patients with aneurysmal subarachnoid hemorrhage has predictive value with respect to infarction and outcome. Of several methods for assessing the amount of subarachnoid blood, none has been subjected to a study of interobserver agreement. We describe our own method, applied in previous studies, in which the amounts of blood in 10 basal cisterns and fissures and in four ventricles are graded separately. In grading single computed tomograms of 182 consecutive patients with subarachnoid hemorrhage, the agreement between pairs of three observers, studied with kappa statistics, was relatively good for individual cisterns or fissures (kappa between 0.35 and 0.65) and ventricles (kappa between 0.47 and 0.74). The Spearman rank correlation coefficients for the sum of the scores for subarachnoid and intraventricular blood were very high. Summed scores for extravasated blood are suitable as a baseline variable in follow-up studies of patients with subarachnoid hemorrhage.
根据多项研究，动脉瘤性蛛网膜下腔出血患者初次计算机断层扫描时的蛛网膜下腔出血量对梗死和预后具有预测价值。在评估蛛网膜下腔出血量的几种方法中，尚未有方法接受观察者间一致性研究。我们描述了我们自己在先前研究中应用的方法，即分别对10个基底池、脑沟和4个脑室内的出血量进行分级。在对182例连续蛛网膜下腔出血患者的单次计算机断层扫描进行分级时，采用kappa统计量对三位观察者之间的一致性进行研究，结果显示，对于单个脑池或脑沟（kappa值在0.35至0.65之间）和脑室（kappa值在0.47至0.74之间），一致性相对较好。蛛网膜下腔和脑室内血液评分总和的Spearman等级相关系数非常高。蛛网膜下腔出血患者随访研究中，外渗血液的总分适合作为基线变量。
