22. European Stroke Conference 203 Vascular imaging Inter-rater Agreement in Carotid Atherosclerotic Plaque Evaluation by 3D Ultrasound M. Bar1, M. Roubec2, R. Farana3, L Ličev4, D. Školoudík5 Faculty Hospital Ostrava, Ostrava, CZECH REPUBLIC1, Faculty Hospital Ostrava, Ostra-va, CZECH REPUBLIC2, Faculty of Mechanical Engineering,VŠB-Technical University Ostra-va, Ostrava, CZECH REPUBLIC3, Faculty of Mechanical Engineering,VŠB-Technical University Ostrava, Ostrava, CZECH REPUBLIC4, Faculty Hospital Ostrava, Ostrava, CZECH REPUBLIC5 Background: The embolisation from atherosclerotic carotid plaque is the most common cause of ischemic stroke and therefore the identification of the high-risk plaque by ultrasound is important. The aim of this study was to investigate an agreement between two investigators in evaluation of ul-trasound parameters of the stability of the plaque. Methods: Individual ultrasound images of carotid plaque in patients after ischemic stroke were evaluated independently by two experienced exam-iners. The following parameters of the plaques were assessed: echogenicity, homogeneity, surface, maximum content and volume. Serial 2D image sequences were obtained using a GE VIVID 7 Pro ultrasound device. Linear motion of probe was automatically synchronized with the pulse of the heart. The edges of the plaque on each image were manually identified by investigators. The volume of plaque was calculated upon the transformation of 2D images into 3D format using the FOTOM PC program. Inter-observer agreement was assessed using weighted kappa coefficient. The agree-ment was considered poor when the kappa was <0.4, good 0.41–0.75, and excellent >0.75. P≤0.05 was considered significant. Results: We enrolled 30 subjects (22males, mean age 72 +/-13 years) to the study and evaluated 28 atherosclerotic plaques. Inter-rater agreement for homogeneity was 96 % (kappa=0.84, p<0.001); for surface 90% (kappa=0.77, p<0.001); for echogenicity 86 % (kappa=0.60 p<0.001). The correlations between measurement of plaque content and volume were poor with kappa=0.31 and 0.30, resp. Conclusion: In our study, the agreement in 2D ultrasound evaluation of atherosclerotic plaque parameters was excellent. Nevertheless, the inter-rater variability for plaque volume measurement was poor. Therefore, the sonographic measurement of plaque volume growth should not be used for the risk-assessment of plaques. 390 © 2013 S. Karger AG, Basel Scientific Programme 204 Vascular imaging Noninvasive Evaluation of Cerebral Arteriovenous Malformations by 4D-CT Angiography us-ing 320-detector Row CT H. Tajiri1, J. Lee2, T. Tsukiyama3, Y. Suzuki4, S. Sekine5, T. Shimizu6, T. Ohiwa7, T. Kurata8, K. Mitsuoka9, D. Kinoshita10, D. Uzuki11, I. Yoshida12, K. Tanabe13, M. Koizumi14 Shonan Kamakura General Hospital Department of Radiology, Kamakura, JAPAN1, Shonan Kamakura General Hospital, Kamakura, JAPAN2, Shonan Kamakura General Hospital, Kamaku-ra, JAPAN3, Shonan Kamakura General Hospital, Kamakura, JAPAN4, Shonan Kamakura General Hospital, Kamakura, JAPAN5, Shonan Kamakura General Hospital, Kamakura, JAPAN6, Shonan Kamakura General Hospital, Kamakura, JAPAN7, Shonan Kamakura General Hospital, Kamaku-ra, JAPAN8, Shonan Kamakura General Hospital, Kamakura, JAPAN9,Shonan Kamakura General Hospital, Kamakura, JAPAN10, Shonan Kamakura General Hospital, Kamakura, JAPAN11, Shonan Kamakura General Hospital, Kamakura, JAPAN12, Shonan Kamakura General Hospital, Kamakura, JAPAN13, Shonan Kamakura General Hospital, Kamakura, JAPAN14 Background and Purpose Patients with higher Spetzler-Martin grade cerebral arteriovenous malformations (AVMs) have poor neurologic and clinical outcomes. Four-dimensional computed tomography angiography (4D-CTA) is new and promising technique in the diagnosis of patients with cerebral AVMs. The purpose of this retrospective study was to inves-tigate the utility of 4D-CTA using whole-brain 320-detector row CT for assessing cerebral AVMs compared with conventional angiography (CA). Materials & Methods Participants included patients admitted to our institution from November 2010 to December 2012 due to cerebral AVMs who underwent both 4D-CTA and CA within 7 days. The diagnosis of cere-bral AVMs was finally confirmed by CA. Two readers reviewed 4D-CTA and CA under consensus regarding AVM detection rate and each component of the AVM (feeders, nidi, drainers) using a four-point grading scale (excellent=3, good=2, fair=1, poor=0), and the Spetzler-Martin grade. Results During the study periods, 14 patients met the inclusion criteria. Mean age was 71.4+-11.4 years, and man was eight. In every case, cerebral AVM was diagnosed by 4D-CTA. The average score for feed-ers, nidi, and drainers was 2.1, 2.3, and 2.4 in 4D-CTA and 2.2, 2.4, and 2.5 in CA, respectively. The median score of Spetzler-Martin grade was 2.5 in both groups. There were no significant differences statistically between two modalities (P<.005). Conclusion 4D-CTA using 320-detector row CT is a very reliable method and offers diagnostic performance equivalent to CA for detecting and predicting the Spetzler-Marin grade of cerebral AVMs.
Karger_ESC London_2013
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