MRA evaluation of aneurysms treated with woven endobridge (WEB) devices or coils: an inter- and intra-observer reliability study.

IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-07-22 DOI:10.1007/s00234-025-03706-x

Pierre-Olivier Comby, Tim E Darsaut, Anass Benomar, Daniela Iancu, Daniel Roy, Roland Jabre, Alain Weill, Nicolas Lecaros, Hanan Alhazmi, Francois Zhu, Thanh N Nguyen, Robert Fahed, William Boisseau, Benjamin Maïer, Johanna Eneling, David Volders, Stephanos Finitsis, Leonardo Olijnyk, Geraud Forestier, Nicolas Raynaud, Adrien Guenego, Jean-François Hak, Vincent L'Allinec, Michael M C Chow, Angélique Bernard, François Lébeaupin, Laura Baptiste, Pierre Thouant, Brivael Lemogne, Marc Lenfant, Jean Raymond

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引用次数: 0

Abstract

Background: Magnetic resonance angiography (MRA) is a commonly used non-invasive imaging modality for the follow-up of treated intracranial aneurysms. The 3-category Montreal classification system is widely used to evaluate treatment outcomes, including aneurysms treated with Woven EndoBridge (WEB) devices or coils. This study aimed to assess the reliability and clinical implications of the Montreal scale for aneurysms imaged with MRA.

Methods: An electronic portfolio of 60 aneurysms (30 treated with WEB devices and 30 with coils) was evaluated by 30 raters from diverse clinical backgrounds. Raters graded aneurysm occlusion using the Montreal classification system and provided management recommendations (delayed follow-up, close follow-up, or re-treatment). Twenty-three raters completed a second evaluation of permuted cases after one month. Reliability was assessed using Gwet's AC2 (κG) coefficients, and the correlation between occlusion grade and management recommendation was analyzed with Cramer's V.

Results: Inter-rater agreement for occlusion grades was substantial (κG = 0.70; 95% CI: 0.66-0.75) and similar for WEB-treated (κG = 0.66; 95% CI: 0.59-0.74) and coiled aneurysms (κG = 0.75; 95% CI: 0.68-0.82). Management decisions showed substantial agreement overall (κG = 0.68; 95% CI: 0.60-0.76). Mean intra-rater agreement was almost perfect (κG = 0.84 ± 0.06). Strong correlations were observed between occlusion grades and management recommendations (mean Cramer's V = 0.78 ± 0.13), with consistent management strategies across treatment modalities.

Conclusion: The Montreal scale demonstrated substantial reliability and clinical relevance for evaluating aneurysms treated with WEB or coils using MRA, supporting its use in non-invasive follow-up protocols.

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编织桥内装置或线圈治疗动脉瘤的MRA评估：观察者之间和观察者内部的可靠性研究。

背景：磁共振血管造影（MRA）是一种常用的非侵入性影像学手段，用于颅内动脉瘤治疗后的随访。3类蒙特利尔分类系统被广泛用于评估治疗结果，包括使用编织EndoBridge装置或线圈治疗的动脉瘤。本研究旨在评估蒙特利尔分级对MRA成像动脉瘤的可靠性和临床意义。方法：由30位来自不同临床背景的评分者对60个动脉瘤（30个用WEB设备治疗，30个用线圈治疗）的电子组合进行评估。评分者使用蒙特利尔分类系统对动脉瘤闭塞进行分级，并提供管理建议（延迟随访、密切随访或重新治疗）。23名评价员在一个月后完成了对排列病例的第二次评估。使用Gwet的AC2 （κG）系数评估可靠性，并使用Cramer's v分析闭塞等级与管理建议之间的相关性。结果：闭塞等级的评级间一致性显著(κG = 0.70；95% CI: 0.66-0.75)， web处理组相似(κG = 0.66；95% CI: 0.59-0.74)和盘状动脉瘤(κG = 0.75；95% ci: 0.68-0.82)。管理层决策总体上一致(κG = 0.68；95% ci: 0.60-0.76)。平均组内一致性几乎完全（κG = 0.84±0.06）。在闭塞等级和治疗建议之间观察到很强的相关性（平均Cramer's V = 0.78±0.13），在不同治疗方式下的治疗策略一致。结论：蒙特利尔量表在MRA评价WEB或线圈治疗的动脉瘤方面具有相当的可靠性和临床相关性，支持其在无创随访方案中的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.