早期脑出血扩大的斑点征和非增强CT标记物的评分者间及评分者内一致性
Inter- and Intrarater Agreement of Spot Sign and Noncontrast CT Markers for Early Intracerebral Hemorrhage Expansion.
作者信息
Nawabi Jawed, Elsayed Sarah, Kniep Helge, Sporns Peter, Schlunk Frieder, McDonough Rosalie, Broocks Gabriel, Dührsen Lasse, Schön Gerhard, Götz Thomalla, Fiehler Jens, Hanning Uta
机构信息
Department of Radiology, Charité School of Medicine and University Hospital Berlin, 10117 Berlin, Germany.
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
出版信息
J Clin Med. 2020 Apr 4;9(4):1020. doi: 10.3390/jcm9041020.
BACKGROUND
The aim of this study was to assess the inter- and intrarater reliability of noncontrast CT (NCCT) markers [Black Hole Sign (BH), Blend Sign (BS), Island Sign (IS), and Hypodensities (HD)] and Spot Sign (SS) on CTA in patients with spontaneous intracerebral hemorrhage (ICH).
METHODS
Patients with spontaneous ICH at three German tertiary stroke centers were retrospectively included. Each CT scan was rated for four NCCT markers and SS on CTA by two radiology residents. Raters were blind to all demographic and outcome data. Inter- and intrarater agreement was determined by Cohen's kappa (κ) coefficient and percentage of agreement.
RESULTS
Interrater agreement was excellent in 473 included patients, ranging from 96% to 99%. Interrater κ ranged from 0.85 (95% CI [0.78-0.91]) to 0.97 (95% CI [0.94-0.99]) for NCCT markers and 0.93 (95% CI [0.88-0.98]) for SS, all -values < 0.001. Intrarrater agreement ranged from 96% to 100%, with κ ranging from 0.85 (95% CI [0.78-0.91]) to 1.00 (95% CI [0.10-0.85]) for NCCT markers and 0.96 (95% CI [0.92-1.00]) for SS, all -values < 0.001.
CONCLUSIONS
NCCT imaging findings and SS on CTA have good-to-excellent inter- and intrarater reliabilities, with the highest agreement for BH and SS.
背景
本研究旨在评估非增强CT（NCCT）标记物[黑洞征（BH）、融合征（BS）、岛征（IS）和低密度影（HD）]以及自发性脑出血（ICH）患者CT血管造影（CTA）上的斑点征（SS）的评分者间和评分者内可靠性。
方法
回顾性纳入德国三个三级卒中中心的自发性ICH患者。两名放射科住院医师对每次CT扫描的四个NCCT标记物和CTA上的SS进行评分。评分者对所有人口统计学和结局数据均不知情。评分者间和评分者内一致性通过科恩kappa（κ）系数和一致性百分比来确定。
结果
473例纳入患者的评分者间一致性极佳，范围为96%至99%。NCCT标记物的评分者间κ值范围为0.85（95%CI[0.78 - 0.91]）至0.97（95%CI[0.94 - 0.99]），SS的评分者间κ值为0.93（95%CI[0.88 - 0.98]），所有P值均<0.001。评分者内一致性范围为96%至100%，NCCT标记物的κ值范围为0.85（95%CI[0.78 - 0.91]）至1.00（95%CI[0.10 - 0.85]），SS的κ值为0.96（95%CI[0.92 - 1.00]），所有P值均<0.001。
结论
NCCT影像学表现和CTA上的SS具有良好至极佳的评分者间和评分者内可靠性，其中BH和SS的一致性最高。
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