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ECR 2013 / C-1656
Diagnostic agreement of the baseline CT and dual-energy CT to differentiate the cerebral hemorrhage from contrast extravasation in patients with acute ischemic stroke after endovascular treatment.
Congress: ECR 2013
Poster No.: C-1656
Type: Scientific Exhibit
Keywords: Outcomes, Haemorrhage, Outcomes analysis, Observer performance, CT, Neuroradiology brain, Interventional vascular, Emergency
Authors: C. Pineda, F. X. ZARCO, A. Lopez Rueda, M. Benegas Urteaga, D. Campodonico, C. Ruiz, M. L. Olondo, S. Capurro, L. Oleaga Zufiría, S. Amaro; Barcelona/ES
DOI:10.1594/ecr2013/C-1656

Results

The dichotomization of each observer is presented in the Table 3 .

 

The interobserver agreement obtained was excellent between experienced neuroradiologists in both conventional CT and dual-energy CT (k = 0,83 and k =1 respectively).

 

We obtain a poor correlation comparing the readings of conventional TC between the experienced neuroradiologists and the second-year resident; k = 0,41 (NR1 vs R2) and k = 0,31 (NR2 vs R2).

 

However, we found a good correlation comparing dual-energy CT readings between the experienced neuroradiologists and the second-year resident; k = 0,68 (NR1 vs R2) and k = 0,68 (NR2 vs R2).

 

The comparison between the kappa index is shown in the Table 4 .

 

The improvement of the R2 k-index is secondary to decrease in detection of false bleeding; in this situation, misclassified patients would not benefit from anticoagulant therapy. The two remaining cases misclassified in dual-energy CT were false bleeding too, so all the cases represents "false positive" of bleeding.

 

However, if the fault was on the contrary, the failure to detect a hemorrhage could expose a bleeding patient to anticoagulation therapy. The mistake and the risk would not be acceptable.

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