Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec;29(12):1685-91.
doi: 10.1177/0883073813506491. Epub 2013 Dec 5.

Reproducibility of detecting silent cerebral infarcts in pediatric sickle cell anemia

Robert I Liem  1 , Jingxia Liu  2 , Mae O Gordon  2 , Bruce A Vendt  3 , Robert C McKinstry 3rd  4 , Michael A Kraut  5 , John J Strouse  6 , William S Ball  7 , Michael R DeBaun  8
Affiliations

Reproducibility of detecting silent cerebral infarcts in pediatric sickle cell anemia

Robert I Liem et al. J Child Neurol. 2014 Dec.

Abstract

Detecting silent cerebral infarcts on magnetic resonance images (MRIs) in children with sickle cell anemia is challenging, yet reproducibility of readings has not been examined in this population. We evaluated consensus rating, inter-, and intra-grader agreement associated with detecting silent cerebral infarct on screening MRI in the Silent Infarct Transfusion Trial. Three neuroradiologists provided consensus decisions for 1073 MRIs. A random sample of 53 scans was reanalyzed in blinded fashion. Agreement between first and second consensus ratings was substantial (κ = 0.70, P < .0001), as was overall intergrader agreement (κ = 0.76, P < .0001). In the test-retest sample, intragrader agreement ranged from κ of 0.57 to 0.76. Consensus decisions were more concordant when MRIs contained more than one larger lesions. Routine use of MRI to screen for silent cerebral infarcts in the research setting is reproducible in sickle cell anemia and agreement among neuroradiologists is sufficient.

Keywords: reliability testing; sickle cell disease; stroke.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests

The authors have no conflicting interests to disclose.

Figures

Figure 1
Figure 1
Consensus decision for negative MRI. Example of MRI in which one grader voted for a qualifying lesion (A, arrow) in the subcortical region of the left frontal lobe but other two graders did not see the lesion. Consensus decision reached was MRI contained no silent cerebral infarct.
Figure 2
Figure 2
Consensus decision for positive MRI. Separate views of an MRI in which two graders detected a qualifying lesion (A, arrow) in the periventricular region of the left parietal lobe but one grader did not. Consensus decision reached was MRI contained a silent cerebral infarct.
See this image and copyright information in PMC

References

    1. Ohene-Frempong K, Weiner SJ, Sleeper LA, et al. Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood. 1998;91(1):288–294. - PubMed
    1. Moser FG, Miller ST, Bello JA, et al. The spectrum of brain MR abnormalities in sickle-cell disease: a report from the Cooperative Study of Sickle Cell Disease. AJNR Am J Neuroradiol. 1996;17(5):965–972. - PMC - PubMed
    1. Pegelow CH, Macklin EA, Moser FG, et al. Longitudinal changes in brain magnetic resonance imaging findings in children with sickle cell disease. Blood. 2002;99(8):3014–3018. - PubMed
    1. Kwiatkowski JL, Zimmerman RA, Pollock AN, et al. Silent infarcts in young children with sickle cell disease. Br J Haematol. 2009;146(3):300–305. - PMC - PubMed
    1. Miller ST, Macklin EA, Pegelow CH, et al. Silent infarction as a risk factor for overt stroke in children with sickle cell anemia: a report from the Cooperative Study of Sickle Cell Disease. J Pediatr. 2001;139(3):385–390. - PubMed

Publication types