Cargando…
Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales
INTRODUCTION: The standardized diagnostic criteria for computed tomographic angiography (CTA) in diagnosis of brain death (BD) are not yet established. The aim of the study was to compare the sensitivity and interobserver agreement of the three previously used scales of CTA for the diagnosis of BD....
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125746/ https://www.ncbi.nlm.nih.gov/pubmed/24801451 http://dx.doi.org/10.1007/s00234-014-1364-9 |
_version_ | 1782329791593054208 |
---|---|
author | Sawicki, Marcin Bohatyrewicz, R. Safranow, K. Walecka, A. Walecki, J. Rowinski, O. Solek-Pastuszka, J. Czajkowski, Z. Guzinski, M. Burzynska, M. Wojczal, J. |
author_facet | Sawicki, Marcin Bohatyrewicz, R. Safranow, K. Walecka, A. Walecki, J. Rowinski, O. Solek-Pastuszka, J. Czajkowski, Z. Guzinski, M. Burzynska, M. Wojczal, J. |
author_sort | Sawicki, Marcin |
collection | PubMed |
description | INTRODUCTION: The standardized diagnostic criteria for computed tomographic angiography (CTA) in diagnosis of brain death (BD) are not yet established. The aim of the study was to compare the sensitivity and interobserver agreement of the three previously used scales of CTA for the diagnosis of BD. METHODS: Eighty-two clinically brain-dead patients underwent CTA with a delay of 40 s after contrast injection. Catheter angiography was used as the reference standard. CTA results were assessed by two radiologists, and the diagnosis of BD was established according to 10-, 7-, and 4-point scales. RESULTS: Catheter angiography confirmed the diagnosis of BD in all cases. Opacification of certain cerebral vessels as indicator of BD was highly sensitive: cortical segments of the middle cerebral artery (96.3 %), the internal cerebral vein (98.8 %), and the great cerebral vein (98.8 %). Other vessels were less sensitive: the pericallosal artery (74.4 %), cortical segments of the posterior cerebral artery (79.3 %), and the basilar artery (82.9 %). The sensitivities of the 10-, 7-, and 4-point scales were 67.1, 74.4, and 96.3 %, respectively (p < 0.001). Percentage interobserver agreement in diagnosis of BD reached 93 % for the 10-point scale, 89 % for the 7-point scale, and 95 % for the 4-point scale (p = 0.37). CONCLUSIONS: In the application of CTA to the diagnosis of BD, reducing the assessment of vascular opacification scale from a 10- to a 4-point scale significantly increases the sensitivity and maintains high interobserver reliability. |
format | Online Article Text |
id | pubmed-4125746 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-41257462014-08-08 Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales Sawicki, Marcin Bohatyrewicz, R. Safranow, K. Walecka, A. Walecki, J. Rowinski, O. Solek-Pastuszka, J. Czajkowski, Z. Guzinski, M. Burzynska, M. Wojczal, J. Neuroradiology Diagnostic Neuroradiology INTRODUCTION: The standardized diagnostic criteria for computed tomographic angiography (CTA) in diagnosis of brain death (BD) are not yet established. The aim of the study was to compare the sensitivity and interobserver agreement of the three previously used scales of CTA for the diagnosis of BD. METHODS: Eighty-two clinically brain-dead patients underwent CTA with a delay of 40 s after contrast injection. Catheter angiography was used as the reference standard. CTA results were assessed by two radiologists, and the diagnosis of BD was established according to 10-, 7-, and 4-point scales. RESULTS: Catheter angiography confirmed the diagnosis of BD in all cases. Opacification of certain cerebral vessels as indicator of BD was highly sensitive: cortical segments of the middle cerebral artery (96.3 %), the internal cerebral vein (98.8 %), and the great cerebral vein (98.8 %). Other vessels were less sensitive: the pericallosal artery (74.4 %), cortical segments of the posterior cerebral artery (79.3 %), and the basilar artery (82.9 %). The sensitivities of the 10-, 7-, and 4-point scales were 67.1, 74.4, and 96.3 %, respectively (p < 0.001). Percentage interobserver agreement in diagnosis of BD reached 93 % for the 10-point scale, 89 % for the 7-point scale, and 95 % for the 4-point scale (p = 0.37). CONCLUSIONS: In the application of CTA to the diagnosis of BD, reducing the assessment of vascular opacification scale from a 10- to a 4-point scale significantly increases the sensitivity and maintains high interobserver reliability. Springer Berlin Heidelberg 2014-05-07 2014 /pmc/articles/PMC4125746/ /pubmed/24801451 http://dx.doi.org/10.1007/s00234-014-1364-9 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Diagnostic Neuroradiology Sawicki, Marcin Bohatyrewicz, R. Safranow, K. Walecka, A. Walecki, J. Rowinski, O. Solek-Pastuszka, J. Czajkowski, Z. Guzinski, M. Burzynska, M. Wojczal, J. Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales |
title | Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales |
title_full | Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales |
title_fullStr | Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales |
title_full_unstemmed | Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales |
title_short | Computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales |
title_sort | computed tomographic angiography criteria in the diagnosis of brain death—comparison of sensitivity and interobserver reliability of different evaluation scales |
topic | Diagnostic Neuroradiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125746/ https://www.ncbi.nlm.nih.gov/pubmed/24801451 http://dx.doi.org/10.1007/s00234-014-1364-9 |
work_keys_str_mv | AT sawickimarcin computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT bohatyrewiczr computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT safranowk computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT waleckaa computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT waleckij computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT rowinskio computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT solekpastuszkaj computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT czajkowskiz computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT guzinskim computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT burzynskam computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales AT wojczalj computedtomographicangiographycriteriainthediagnosisofbraindeathcomparisonofsensitivityandinterobserverreliabilityofdifferentevaluationscales |