This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chikos, P. M. Articles by Strandness, D. E. Search for Related Content PubMed PubMed Citation Articles by Chikos, P. M. Articles by Strandness, D. E., Jr Pubmed/NCBI databases Medline Plus Health Information Carotid Artery Disease

Stroke, Vol 14, 885-892, Copyright © 1983 by American Heart Association

ARTICLES

Observer variability in evaluating extracranial carotid artery stenosis

PM Chikos, LD Fisher, JH Hirsch, JD Harley, BL Thiele and DE Strandness Jr

One hundred twenty eight cervical carotid arteriograms were twice viewed by three readers for the evaluation of atherosclerotic disease at the carotid bifurcation. Stenoses were estimated using calipers to the nearest 5% and lesions were qualitatively characterized as smooth, irregular, or ulcerated. The intraobserver correlation coefficient between estimates of percent stenosis was .94 overall and .98 for the internal carotid artery. The average intraobserver variability in estimating percent stenosis was 5.23% for all vessels and 6.04% with a standard deviation of 8.09% for the internal carotid artery. The intraobserver percent agreement at a fixed stenosis is defined as the percent of the time one reader on two readings would read at least the fixed percent stenosis among cases that might be read as having the fixed percent stenosis. The intraobserver percent agreement rate for the internal carotid artery was 95.9% at greater than 0% stenosis, 90.4% for 50% or greater stenosis, and 96.8% for 100% stenosis (total occlusion). The interobserver correlation coefficient between readers was .92 overall and .97 for the internal carotid artery. The absolute difference in percent stenosis between readers was 7.21% for all vessels and 8.64% for the internal carotid artery with a standard deviation of 9.5%. The interobserver agreement rate for the internal carotid artery at greater than 0% stenosis was 93.0%, 85.4% for 50% or greater stenosis and 96.8% at 100% stenosis. The addition of oblique views had no statistical effect on estimates of percent stenosis but increased the frequency with which irregularity and ulceration were diagnosed in the internal carotid artery.

This article has been cited by other articles:

				J. E. Heiserman Measurement Error of Percent Diameter Carotid Stenosis Determined by Conventional Angiography: Implications for Noninvasive Evaluation AJNR Am. J. Neuroradiol., September 1, 2005; 26(8): 2102 - 2107. [Abstract] [Full Text] [PDF]

				D J A Connolly, D Birchall, and A Gholkar Current theory in imaging of intracranial vascular disease Imaging, October 1, 2002; 14(5): 396 - 408. [Abstract] [Full Text] [PDF]

				K. Logason, S. Karacagil, A. Tulga Ulus, and H.-G. Hardemark The Impact of Different Spectral Doppler Criteria on the Proportion of High-Grade Internal Carotid Artery Stenosis in Patients Undergoing Duplex Scanning Angiology, May 1, 2002; 53(3): 297 - 301. [Abstract] [PDF]

				K. Logason, S. Karacagil, H.-G. Hardemark, A. Bostrom, A. Hellberg, and C. Ljungman Carotid Artery Endarterectomy Solely Based on Duplex Scan Findings Vascular and Endovascular Surgery, January 1, 2002; 36(1): 9 - 15. [Abstract] [PDF]

				K-T Khaw and P D Griffiths Non-invasive imaging of the cervical carotid and vertebral arteries Imaging, December 15, 2001; 13(5): 376 - 390. [Abstract] [Full Text] [PDF]

				P. M. Rothwell, S. T. Pendlebury, J. Wardlaw, and C. P. Warlow Critical Appraisal of the Design and Reporting of Studies of Imaging and Measurement of Carotid Stenosis Stroke, June 1, 2000; 31(6): 1444 - 1450. [Abstract] [Full Text] [PDF]

				D. E. Strandness Jr Angiography Before Carotid Endarterectomy--No Arch Neurol, August 1, 1995; 52(8): 832 - 833. [Abstract] [PDF]

				M. R. Mayberg and H. R. Winn Endarterectomy for Asymptomatic Carotid Artery Stenosis: Resolving the Controversy JAMA, May 10, 1995; 273(18): 1459 - 1461. [Abstract] [PDF]

				C.F. Bladin, A.V. Alexandrov, J. Murphy, R. Maggisano, and J.W. Norris Carotid Stenosis Index : A New Method of Measuring Internal Carotid Artery Stenosis Stroke, February 1, 1995; 26(2): 230 - 234. [Abstract] [Full Text]

				R. W. Hobson, D. G. Weiss, W. S. Fields, J. Goldstone, W. S. Moore, J. B. Towne, C. B. Wright, and Veterans Affairs Cooperative Study Group Efficacy of Carotid Endarterectomy for Asymptomatic Carotid Stenosis N. Engl. J. Med., January 28, 1993; 328(4): 221 - 227. [Abstract] [Full Text]

				C. Estol, D. Claassen, W. Hirsch, L. Wechsler, and J. Moossy Correlative Angiographic and Pathologic Findings in the Diagnosis of Ulcerated Plaques in the Carotid Artery Arch Neurol, July 1, 1991; 48(7): 692 - 694. [Abstract] [PDF]

				W. T. Longstreth Jr, T. D. Koepsell, and G. van Belle Clinical Neuroepidemiology: I. Diagnosis Arch Neurol, October 1, 1987; 44(10): 1091 - 1099. [Abstract] [PDF]

				M. Fisher, J. Ahmadi, C.-S. Zee, and J. M. Weiner Variability in Arteriographic Assessment of the Carotid Bifurcation Angiology, February 1, 1987; 38(2): 116 - 120. [Abstract] [PDF]

				D. F. Bandyk, A. W. Levine, L. Pohl, and J. B. Towne Classification of Carotid Bifurcation Disease Using Quantitative Doppler Spectrum Analysis Arch Surg, March 1, 1985; 120(3): 306 - 314. [Abstract] [PDF]