title: Interpretation of renal angiography by radiologists.
abstract: OBJECTIVE
  Different radiologists may show considerable variation in their interpretation of renal angiograms. We therefore wished to establish the reliability of their interpretation.
  
  
  METHODS
  Assessment of the intra- and inter-observer agreement of the interpretation of renal angiograms.
  
  
  METHODS
  Tertiary referral university hospital.
  
  
  METHODS
  Hypertensive patients suspected of renovascular hypertension on clinical grounds or on the basis of renography.
  
  
  METHODS
  Patients were prospectively selected to undergo a renal angiography via the femoral approach.
  
  
  METHODS
  Intra- and inter-observer agreement of the degree and site of stenosis.
  
  
  RESULTS
  The difference between two estimates of the degree of stenosis ranged from 0 to 65% for the individual readers and from 0 to 75% between two readers. When the site of greatest stenosis was in the origin of the renal artery, the intra-observer agreement kappa ranged from 0.54-0.71, the inter-observer agreement across multiple readers being 0.43. In a post hoc analysis using two different cut-off points of stenosis (50 or 70%), the intra- and inter-observer agreement was better at the 70% cut-off-point. In a subset of patients with stenosis and a renin ratio greater than 1.5, both the intra- and inter-observer agreement were much better than when all angiograms were considered.
  
  
  CONCLUSIONS
  Assessment of the diagnostic performance of three experienced radiologists in their interpretation of renal artery angiograms indicates that the intra- and inter-observer agreement with respect to their estimates of the degree of stenosis and the site of greatest stenosis are rather poor but their diagnostic performance improves in patients with stenosis and a renin ratio greater than 1.5. There is a need for more objective assessment of renal artery lesions.
authors.affiliation: Department of Internal Medicine, University Hospital Maastricht, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Schreij
authors.forename: M W
authors.initials: MW
authors.lastname: de Haan
authors.forename: T K
authors.initials: TK
authors.lastname: Oei
authors.forename: D
authors.initials: D
authors.lastname: Koster
authors.forename: P W
authors.initials: PW
authors.lastname: de Leeuw
mesh_terms: D000792:Angiography / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D006977:Hypertension, Renal / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015588:Observer Variation; D011446:Prospective Studies; D011871:Radiology / Q000592:standards / Q000706:statistics & numerical data*; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012083:Renin / Q000097:blood; D015203:Reproducibility of Results
chemical_list: D012083:Renin