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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....

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Autores principales: Sawicki, Marcin, Bohatyrewicz, R., Safranow, K., Walecka, A., Walecki, J., Rowinski, O., Solek-Pastuszka, J., Czajkowski, Z., Guzinski, M., Burzynska, M., Wojczal, J.
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
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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.
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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
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