ArticleEuropean radiology2022
Non-contrast CT markers of intracerebral hematoma expansion: a reliability study.
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Prediction of intracerebral hemorrhage hematoma expansion: value of a novel deep learning system score.European radiology · 2026Article
- Review
- Noncontrast CT-based deep learning for predicting intracerebral hemorrhage expansion incorporating growth of intraventricular hemorrhage.Scientific reports · 2025Article
- Differential Risk Factors for Hematoma Expansion in Deep and Lobar Intracerebral Hemorrhage.Neurocritical care · 2025Article
- An Artificial Intelligence Algorithm Integrated into the Clinical Workflow Can Ensure High Quality Acute Intracranial Hemorrhage CT Diagnostic.Clinical neuroradiology · 2025Article
- Predictors and Outcomes of Hematoma Expansion and Neurological Decline in Intracerebral Hemorrhage: A Multisite Mobile Stroke Unit Study.Stroke (Hoboken, N.J.) · 2025Article
- Evaluating the value of machine learning models for predicting hematoma expansion in acute spontaneous intracerebral hemorrhage based on CT imaging features of hematomas and surrounding oedema.Frontiers in neurology · 2025Article
- Combining Non-Contrast CT Signs With Onset-to-Imaging Time to Predict the Evolution of Intracerebral Hemorrhage.Korean journal of radiology · 2024Article
- Review
- NCCT Markers of Intracerebral Hemorrhage Expansion Using Revised Criteria: An External Validation of Their Predictive Accuracy.AJNR. American journal of neuroradiology · 2023Article
- Noncontrast Computed Tomography Markers Associated with Hematoma Expansion: Analysis of a Multicenter Retrospective Study.Brain sciences · 2023Article
- Diagnostic Accuracy and Reliability of Noncontrast Computed Tomography Markers for Acute Hematoma Expansion among Radiologists.Tomography (Ann Arbor, Mich.) · 2022Article
- Combining modified Graeb score and intracerebral hemorrhage score to predict poor outcome in patients with spontaneous intracerebral hemorrhage undergoing surgical treatment.Frontiers in neurology · 2022Article
Corrections and comments
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Authors and funding
20 authors at 1 institution in 1 country.
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Abstract
objectivesWe evaluated whether clinicians agree in the detection of non-contrast CT markers of intracerebral hemorrhage (ICH) expansion.
methodsFrom our local dataset, we randomly sampled 60 patients diagnosed with spontaneous ICH. Fifteen physicians and trainees (Stroke Neurology, Interventional and Diagnostic Neuroradiology) were trained to identify six density (Barras density, black hole, blend, hypodensity, fluid level, swirl) and three shape (Barras shape, island, satellite) expansion markers, using standardized definitions. Thirteen raters performed a second assessment. Inter- and intra-rater agreement were measured using Gwet's AC
resultsAlmost perfect inter-rater agreement was observed for the swirl (0.85, 95% CI: 0.78-0.90) and fluid level (0.84, 95% CI: 0.76-0.90) markers, while the hypodensity (0.67, 95% CI: 0.56-0.76) and blend (0.62, 95% CI: 0.51-0.71) markers showed substantial agreement. Inter-rater agreement was otherwise moderate, and comparable between density and shape markers. Inter-rater agreement was lower for the three markers that require the rater to identify one specific axial slice (Barras density, Barras shape, island: 0.46, 95% CI: 0.40-0.52 versus others: 0.60, 95% CI: 0.56-0.63). Inter-observer agreement did not differ when stratified for raters' experience, hematoma location, volume, or anticoagulation status. Intra-rater agreement was substantial to almost perfect for all but the black hole marker.
conclusionIn a large sample of raters with different backgrounds and expertise levels, only four of nine non-contrast CT markers of ICH expansion showed substantial to almost perfect inter-rater agreement. KEY POINTS: • In a sample of 15 raters and 60 patients, only four of nine non-contrast CT markers of ICH expansion showed substantial to almost perfect inter-rater agreement (Gwet's AC
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