Reliability assessment of computerized tomography scanning measurements in intracerebral hematoma

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>As one of the aspects of the International Surgical Trial in Intracerebral Haemorrhage (STICH), prerandomization computerized tomography (CT) scans were collected. In the present study the authors determined the inter-and intraobserver variability of various parameters pertinent to CT scans obtained in patients with intracerebral hematomas (ICHs).</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A protocol was devised to analyze CT scans in a uniform and systematic manner. Each observer evaluated the same set of scans twice, with a minimum 2-month interval between assessments. In addition to noting the side and the sites of involvement, the observers measured the scale present on the scan itself and the length, breadth, height, and depth of the spontaneous ICH as well as the midline shift. The intraclass correlation was very high (κ 0.8–1) for the measurements of volume, depth, and midline shift. Good interobserver agreement (κ 0.8–1) was demonstrated with regard to involvement of basal ganglia or thalamus, presence of intraventricular extension, and the side of the hematoma. Agreement was substantial (κ 0.61–0.8) with regard to identifying primary involvement of particular lobes. Agreement was moderate (κ 0.41–0.6) on the presence or absence of hydrocephalus. When comparing the first and the second sets of readings, the intraobserver agreement was good (80–100%).</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The study quantifies the degree of inter- and intraobserver agreement regarding evaluation of CT scans in patients with ICH when conducted in accordance with a set protocol.</jats:p></jats:sec>

Apolipoprotein E Modifies Neurological Outcome by Affecting Cerebral Edema but not Hematoma Size after Intracerebral Hemorrhage in Humans

“…We chose to use the surrogate measurement of MLS as it is a fairly concrete calculation and has been shown to be stable across interpreters. (30) In contrast, volumetric measurement of cerebral edema by CT can be inconsistent and unreliable after ICH. (31) In agreement with prior studies, (32, 33) MLS correlated with poor functional outcome, which in our cohort consisted of mRS and GOS at time of hospital discharge.…”

Accuracy and Clinical Usefulness of Intracerebral Hemorrhage Grading Scores

“…Although the mICH score takes hydrocephalus into account, we excluded this because we felt that the presence or absence of this CT finding is subjective and has been shown to have poor interobserver agreement in this setting. 12 The survival status and date of death of nonsurvivors were obtained on October 21, 2011, via the Medical Research Information Service, Southport, United Kingdom, allowing a minimum follow-up period of 370 days for all cases. Data collection and image analysis were conducted before collection of survival data and were thus blinded to outcome.…”

Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training

“…The high variability in those studies was attributed to the subjective interpretation of the presence or absence of hydrocephalus. [27] There are numerous quantitative methods to evaluate hydrocephalus but VCR is now being increasingly used as a substitute for subjective analysis. Van Zagten et al .…”