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Intraobserver and interobserver variability in CT angiography and MR angiography measurements of the size of cerebral aneurysms

  • Diagnostic Neuroradiology
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Abstract

Purpose

Accurate and reliable measurement of aneurysm size is important for treatment planning. The purpose of this study was to determine intraobserver and interobserver variability of CTA and MRA for measurement of the size of cerebral aneurysms.

Methods

Thirty patients with 33 unruptured cerebral aneurysms (saccular, >3 mm in their maximal dimension, with no daughter sacs or lobulations) who underwent 256-row multislice CTA, 3-D TOF MRA at 3.0T, and 3D rotational angiography (3DRA) were retrospectively analyzed. Three independent observers measured the neck, height, and width of the aneurysms using the CTA and MRA images. Intraobserver and interobserver variability of CTA and MRA measurements was evaluated using the standardized difference and intraclass correlation coefficient, with 3DRA measurements as the reference standard. In addition, the mean values of the measurements using CTA and MRA were compared with those using 3DRA.

Results

The overall intraobserver and interobserver standardized differences in CTA/MRA were 12.83–15.92%/13.48–17.45% and 14.08–17.00%/12.08–17.67%, respectively. The overall intraobserver and interobserver intraclass correlation coefficients of CTA/MRA were 0.88–0.98/0.84–0.96 and 0.86–0.98/0.85–0.95, respectively. Compared to the height and width measurements, measurements of the neck dimensions showed higher intraobserver and interobserver variability. The sizes of the cerebral aneurysms measured by CTA and MRA were 1.13–9.26 and 5.20–9.67% larger than those measured by 3DRA, respectively; however, these differences were not statistically significant.

Conclusion

There were no noticeable differences between intraobserver and interobserver variability for both CTA- and MRA-based measurements of the size of cerebral aneurysms.

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Abbreviations

CTA:

Computed tomography angiography

MRA:

Magnetic resonance angiography

3DRA:

3D rotational angiography

TOF:

Time-of-flight

SD:

Standardized difference

ICC:

Intraclass correlation coefficient

SAH:

Subarachnoid hemorrhage

VR:

Volume rendering

MIP:

Maximum intensity projection

LOA:

Limits of agreement

CI:

Confidence interval

PC:

Phase-contrast

CE:

Contrast enhanced

SSD:

Shaded surface display

DSA:

Digital subtracted angiography

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Authors and Affiliations

  1. Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea

    Hye Jeong Kim

  2. Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150, Seongan-ro Gangdong-Gu, Seoul, 134-701, South Korea

    Dae Young Yoon & Hyung Jin Lee

  3. Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do, South Korea

    Eun Soo Kim

  4. Department of Neurosurgery, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea

    Hong Jun Jeon, Jong Young Lee & Byung-Moon Cho

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  1. Hye Jeong Kim
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  3. Eun Soo Kim
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Correspondence to Dae Young Yoon.

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The authors declare that they have no conflict of interest.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Kim, H.J., Yoon, D.Y., Kim, E.S. et al. Intraobserver and interobserver variability in CT angiography and MR angiography measurements of the size of cerebral aneurysms. Neuroradiology 59, 491–497 (2017). https://doi.org/10.1007/s00234-017-1826-y

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  • DOI: https://doi.org/10.1007/s00234-017-1826-y

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