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AJNR - American Journal of Neuroradiology

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Inter- and Intraobserver Variability in the Assessment of Brain Arteriovenous Malformation Angioarchitecture and Endovascular Treatment Results

D. Iancu-Gontard^a, A. Weill^a, F. Guilbert^a, T. Nguyen^a, J. Raymond^a and D. Roy^a

^a From the Department of Radiology, Interventional Neuroradiology Section, Centre Hospitalier de l’Université de Montréal, Notre-Dame Hospital, Montreal, PQ, Canada

View larger version (28K): [in this window] [in a new window]   Fig 1. Intra- and interobserver agreement calculated for each architectural feature, measured by unweighted or weighted with 95% CI. Observer agreement was considered good (substantial to almost perfect) when the value was above 0.60.

View larger version (34K): [in this window] [in a new window]   Fig 2. Anteroposterior (A) and lateral (B and C) views of the right carotid angiogram that shows a right frontal BAVM. There was agreement for the Spetzler-Martin grade II collateral circulation and the presence of the carotid aneurysm. However, we noted a disagreement about the presence or absence of a nidus aneurysm (arrow).

View larger version (45K): [in this window] [in a new window]   Fig 3. Axial CT scan (A) showing an occipital hematoma in a 23-year-old man. Anteroposterior (B) and lateral (C) views of the right carotid angiogram showing a right occipital BAVM. There was agreement for the Spetzler-Martin grade, including the size, eloquence, venous drainage, as well as for the presence of a paranidal aneurysm responsible for hemorrhage. However, interobserver disagreement was about the precise location of the aneurysm, either on the feeding artery or into the nidus.