TY - JOUR
T1 - Diagnostic reliability of the Berlin classification for complex MCA aneurysms—usability in a series of only giant aneurysms
AU - Wessels, Lars
AU - Fekonja, Lucius Samo
AU - Achberger, Johannes
AU - Dengler, Julius
AU - Czabanka, Marcus
AU - Hecht, Nils
AU - Schneider, Ulf
AU - Tkatschenko, Dimitri
AU - Schebesch, Karl Michael
AU - Schmidt, Nils Ole
AU - Mielke, Dorothee
AU - Hosch, Henning
AU - Ganslandt, Oliver
AU - Gräwe, Alexander
AU - Hong, Bujung
AU - Walter, Jan
AU - Güresir, Erdem
AU - Bijlenga, Philippe
AU - Haemmerli, Julien
AU - Maldaner, Nicolai
AU - Marbacher, Serge
AU - Nurminen, Ville
AU - Zitek, Hynek
AU - Dammers, Ruben
AU - Kato, Naoki
AU - Linfante, Italo
AU - Pedro, Maria Teresa
AU - Wrede, Karsten
AU - Wang, Wei Te
AU - Wostrack, Maria
AU - Vajkoczy, Peter
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Background and objective: The main challenge of bypass surgery of complex MCA aneurysms is not the selection of the bypass type but the initial decision-making of how to exclude the affected vessel segment from circulation. To this end, we have previously proposed a classification for complex MCA aneurysms based on the preoperative angiography. The current study aimed to validate this new classification and assess its diagnostic reliability using the giant aneurysm registry as an independent data set. Methods: We reviewed the pretreatment neuroimaging of 51 patients with giant (> 2.5 cm) MCA aneurysms from 18 centers, prospectively entered into the international giant aneurysm registry. We classified the aneurysms according to our previously proposed Berlin classification for complex MCA aneurysms. To test for interrater diagnostic reliability, the data set was reviewed by four independent observers. Results: We were able to classify all 51 aneurysms according to the Berlin classification for complex MCA aneurysms. Eight percent of the aneurysm were classified as type 1a, 14% as type 1b, 14% as type 2a, 24% as type 2b, 33% as type 2c, and 8% as type 3. The interrater reliability was moderate with Fleiss’s Kappa of 0.419. Conclusion: The recently published Berlin classification for complex MCA aneurysms showed diagnostic reliability, independent of the observer when applied to the MCA aneurysms of the international giant aneurysm registry.
AB - Background and objective: The main challenge of bypass surgery of complex MCA aneurysms is not the selection of the bypass type but the initial decision-making of how to exclude the affected vessel segment from circulation. To this end, we have previously proposed a classification for complex MCA aneurysms based on the preoperative angiography. The current study aimed to validate this new classification and assess its diagnostic reliability using the giant aneurysm registry as an independent data set. Methods: We reviewed the pretreatment neuroimaging of 51 patients with giant (> 2.5 cm) MCA aneurysms from 18 centers, prospectively entered into the international giant aneurysm registry. We classified the aneurysms according to our previously proposed Berlin classification for complex MCA aneurysms. To test for interrater diagnostic reliability, the data set was reviewed by four independent observers. Results: We were able to classify all 51 aneurysms according to the Berlin classification for complex MCA aneurysms. Eight percent of the aneurysm were classified as type 1a, 14% as type 1b, 14% as type 2a, 24% as type 2b, 33% as type 2c, and 8% as type 3. The interrater reliability was moderate with Fleiss’s Kappa of 0.419. Conclusion: The recently published Berlin classification for complex MCA aneurysms showed diagnostic reliability, independent of the observer when applied to the MCA aneurysms of the international giant aneurysm registry.
KW - Cerebral bypass
KW - Giant aneurysm
KW - MCA aneurysm
UR - http://www.scopus.com/inward/record.url?scp=85090926712&partnerID=8YFLogxK
U2 - 10.1007/s00701-020-04565-6
DO - 10.1007/s00701-020-04565-6
M3 - Article
C2 - 32929543
AN - SCOPUS:85090926712
SN - 0001-6268
VL - 162
SP - 2753
EP - 2758
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 11
ER -