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Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke.

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Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke. / Saur, Dorothee; Kucinski, Thomas; Grzyska, Ulrich; Eckert, Bernd; Eggers, Christian; Niesen, Wolf; Schoder, Volker; Zeumer, Hermann; Weiller, Cornelius; Röther, Joachim.

In: AM J NEURORADIOL, Vol. 24, No. 5, 5, 2003, p. 878-885.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Saur, D, Kucinski, T, Grzyska, U, Eckert, B, Eggers, C, Niesen, W, Schoder, V, Zeumer, H, Weiller, C & Röther, J 2003, 'Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke.', AM J NEURORADIOL, vol. 24, no. 5, 5, pp. 878-885. <http://www.ncbi.nlm.nih.gov/pubmed/12748088?dopt=Citation>

APA

Saur, D., Kucinski, T., Grzyska, U., Eckert, B., Eggers, C., Niesen, W., Schoder, V., Zeumer, H., Weiller, C., & Röther, J. (2003). Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke. AM J NEURORADIOL, 24(5), 878-885. [5]. http://www.ncbi.nlm.nih.gov/pubmed/12748088?dopt=Citation

Vancouver

Saur D, Kucinski T, Grzyska U, Eckert B, Eggers C, Niesen W et al. Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke. AM J NEURORADIOL. 2003;24(5):878-885. 5.

Bibtex

@article{eb68bf293beb4518aebb14f278ebe704,
title = "Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke.",
abstract = "BACKGROUND AND PURPOSE: Previous acute stroke studies found diffusion-weighted (DW) imaging superior to CT for detection of early ischemic signs (EIS). However, these findings were confounded by a large time interval in favor of DW imaging. We compared DW images and CT scans obtained with a short time delay in patients with acute stroke to define the sensitivity and interrater agreement of both imaging techniques. METHODS: CT scans and DW images were obtained within 6 hours of symptom onset in 46 patients with acute stroke. Three neuroradiologists and three neurologists reviewed the images for EIS in five regions of the middle cerebral artery (MCA) territory and estimated the extent of EIS ( one-third of the MCA territory). RESULTS: The mean delay between imaging with both modalities was 24.5 minutes (range, 10-41 minutes). Forty-five of 46 patients had an ischemic stroke. EIS were seen on 33 of 45 CT scans (73% sensitivity; 95% confidence interval [CI]: 58-85%) and on 42 of 45 DW images (93% sensitivity; 94% CI: 82-99%). Interrater agreement was moderate (kappa = 0.57) for CT and excellent (kappa = 0.85) for DW imaging. CT studies had a moderate interrater agreement for estimation of EIS greater than one-third of the MCA territory (kappa = 0.40), whereas DW imaging showed good results (kappa = 0.68). Sensitivity for detection of greater than one-third of the MCA territory was equally poor (57%, 95% CI: 29-82%) for both CT and DW imaging. CONCLUSION: DW imaging helped identify EIS with higher sensitivity than that of CT. The interrater variability of the one-third rule was high for CT, and thus the clinical applicability of CT is limited. Our results support the application of stroke MR imaging for the treatment of patients with acute stroke.",
author = "Dorothee Saur and Thomas Kucinski and Ulrich Grzyska and Bernd Eckert and Christian Eggers and Wolf Niesen and Volker Schoder and Hermann Zeumer and Cornelius Weiller and Joachim R{\"o}ther",
year = "2003",
language = "Deutsch",
volume = "24",
pages = "878--885",
journal = "AM J NEURORADIOL",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
number = "5",

}

RIS

TY - JOUR

T1 - Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke.

AU - Saur, Dorothee

AU - Kucinski, Thomas

AU - Grzyska, Ulrich

AU - Eckert, Bernd

AU - Eggers, Christian

AU - Niesen, Wolf

AU - Schoder, Volker

AU - Zeumer, Hermann

AU - Weiller, Cornelius

AU - Röther, Joachim

PY - 2003

Y1 - 2003

N2 - BACKGROUND AND PURPOSE: Previous acute stroke studies found diffusion-weighted (DW) imaging superior to CT for detection of early ischemic signs (EIS). However, these findings were confounded by a large time interval in favor of DW imaging. We compared DW images and CT scans obtained with a short time delay in patients with acute stroke to define the sensitivity and interrater agreement of both imaging techniques. METHODS: CT scans and DW images were obtained within 6 hours of symptom onset in 46 patients with acute stroke. Three neuroradiologists and three neurologists reviewed the images for EIS in five regions of the middle cerebral artery (MCA) territory and estimated the extent of EIS ( one-third of the MCA territory). RESULTS: The mean delay between imaging with both modalities was 24.5 minutes (range, 10-41 minutes). Forty-five of 46 patients had an ischemic stroke. EIS were seen on 33 of 45 CT scans (73% sensitivity; 95% confidence interval [CI]: 58-85%) and on 42 of 45 DW images (93% sensitivity; 94% CI: 82-99%). Interrater agreement was moderate (kappa = 0.57) for CT and excellent (kappa = 0.85) for DW imaging. CT studies had a moderate interrater agreement for estimation of EIS greater than one-third of the MCA territory (kappa = 0.40), whereas DW imaging showed good results (kappa = 0.68). Sensitivity for detection of greater than one-third of the MCA territory was equally poor (57%, 95% CI: 29-82%) for both CT and DW imaging. CONCLUSION: DW imaging helped identify EIS with higher sensitivity than that of CT. The interrater variability of the one-third rule was high for CT, and thus the clinical applicability of CT is limited. Our results support the application of stroke MR imaging for the treatment of patients with acute stroke.

AB - BACKGROUND AND PURPOSE: Previous acute stroke studies found diffusion-weighted (DW) imaging superior to CT for detection of early ischemic signs (EIS). However, these findings were confounded by a large time interval in favor of DW imaging. We compared DW images and CT scans obtained with a short time delay in patients with acute stroke to define the sensitivity and interrater agreement of both imaging techniques. METHODS: CT scans and DW images were obtained within 6 hours of symptom onset in 46 patients with acute stroke. Three neuroradiologists and three neurologists reviewed the images for EIS in five regions of the middle cerebral artery (MCA) territory and estimated the extent of EIS ( one-third of the MCA territory). RESULTS: The mean delay between imaging with both modalities was 24.5 minutes (range, 10-41 minutes). Forty-five of 46 patients had an ischemic stroke. EIS were seen on 33 of 45 CT scans (73% sensitivity; 95% confidence interval [CI]: 58-85%) and on 42 of 45 DW images (93% sensitivity; 94% CI: 82-99%). Interrater agreement was moderate (kappa = 0.57) for CT and excellent (kappa = 0.85) for DW imaging. CT studies had a moderate interrater agreement for estimation of EIS greater than one-third of the MCA territory (kappa = 0.40), whereas DW imaging showed good results (kappa = 0.68). Sensitivity for detection of greater than one-third of the MCA territory was equally poor (57%, 95% CI: 29-82%) for both CT and DW imaging. CONCLUSION: DW imaging helped identify EIS with higher sensitivity than that of CT. The interrater variability of the one-third rule was high for CT, and thus the clinical applicability of CT is limited. Our results support the application of stroke MR imaging for the treatment of patients with acute stroke.

M3 - SCORING: Zeitschriftenaufsatz

VL - 24

SP - 878

EP - 885

JO - AM J NEURORADIOL

JF - AM J NEURORADIOL

SN - 0195-6108

IS - 5

M1 - 5

ER -