European radiology
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
The non-invasive detection of intracranial aneurysms: are neuroradiologists any better than other observers?
Can non-neuroradiologists detect intracranial aneurysms as well as neuroradiologists, using CT and MR angiography? Sixty patients undergoing intra-arterial digital subtraction angiography (IADSA) to detect aneurysms also underwent computed tomographic angiography (CTA) and time-of-flight magnetic resonance angiography (MRA). Consensus review of IADSA by two neuroradiologists was the reference standard. Two neuroradiologists, a neurosurgeon, a neuroradiographer and a general radiologist blinded to IADSA, plain CT and clinical data, independently reviewed hard-copy base and reconstructed maximum intensity projection images of the CTA and MRA studies. ⋯ Agreement with IADSA was "good" for neuroradiologists: kappa 0.73 for CTA, and 0.63 for MRA. For the other observers, agreement with IADSA was "moderate": kappa 0.59 for CTA, and 0.56 for MRA. Neuroradiologists performed consistently better than the other observers, although differences did not reach statistical significance.