1. MRI Interscanner Agreement of the Association between the Susceptibility Vessel Sign and Histologic Composition of Thrombi
- Author
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Béatrice Delasalle, Lili Detraz, Hubert Desal, Romain Bourcier, Olivier Naggara, Frédérique Toulgoat, Claire Toquet, Imad Derraz, Jean Michel Serfaty, and M. Mirza
- Subjects
medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Diagnostic accuracy ,medicine.disease ,Confidence interval ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Neurology (clinical) ,Thrombus ,Nuclear medicine ,business ,Stroke ,030217 neurology & neurosurgery ,Kappa ,circulatory and respiratory physiology ,Acute stroke - Abstract
BACKGROUND AND PURPOSE The susceptibility vessel sign (SVS) on magnetic resonance imaging (MRI) is related to thrombus location, composition, and size in acute stroke. No previous study has determined its inter-MRI scanner variability. We aimed to compare the diagnostic accuracy in-vitro of four different MRI scanners for the characterization of histologic thrombus composition. METHODS Thirty-five manufactured thrombi analogs of different composition that were histologically categorized as fibrin-dominant, mixed, or red blood cell (RBC)-dominant were scanned on four different MRI units with T2* sequence. Nine radiologists, blinded to thrombus composition and MRI scanner model, classified twice, in a 2-week interval, the SVS of each thrombus as absent, questionable, or present. We calculated the weighted kappa with 95% confidence interval (CI), sensitivity, specificity and accuracy of the SVS on each MRI scanner to detect RBC-dominant thrombi. RESULTS The SVS was present in 42%, absent in 33%, and questionable in 25% of thrombi. The interscanner agreement was moderate to good, ranging from .45 (CI: .37-.52) to .67 (CI: .61-.74). The correlation between the SVS and the thrombus composition was moderate (κ: .50 [CI: .44-.55]) to good κ: .76 ([CI: .72-.80]). Sensitivity, specificity, and accuracy to identify RBC-dominant clots were significantly different between MRI scanners (P < .001). CONCLUSION The diagnostic accuracy of SVS to determine thrombus composition varies significantly among MRI scanners. Normalization of T2*sequences between scanners may be needed to better predict thrombus composition in multicenter studies.
- Published
- 2017
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