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Updated: May 16, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Published on: October 20, 2017

A new classification scheme for spinal vascular abnormalities based on angiographic features.

Adnan I Qureshi1

  • 1Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, MN, USA. aiqureshi@hotmail.com

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|December 12, 2012
PubMed
Summary

A new classification scheme for spinal vascular malformations demonstrated good interobserver reliability among neuroradiologists. This system for arteriovenous fistulas and arteriovenous malformations is reliable for consistent diagnosis.

Keywords:
Spinal cord malformationsarteriovenous fistulaarteriovenous malformationclassificationinterobserver reliability

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Area of Science:

  • Neuroradiology
  • Vascular Imaging
  • Medical Classification Systems

Background:

  • Spinal vascular malformations, including arteriovenous fistulas (AVFs) and arteriovenous malformations (AVMs), require accurate classification.
  • Existing classification schemes may lack sufficient interobserver reliability.

Purpose of the Study:

  • To evaluate the interobserver reliability of a novel classification scheme for spinal AVFs and AVMs based on angiographic findings.
  • To assess the scheme's consistency among different levels of rater experience.

Main Methods:

  • Seven raters (five fellows, two interventionalists) independently classified 26 spinal vascular malformations from angiographic images.
  • Interobserver reliability was quantified using the median weighted kappa statistic for the overall scheme and individual grades.

Main Results:

  • The proposed classification scheme achieved an overall interobserver reliability of Kappa = 0.53.
  • Individual grade reliability ranged from Kappa = 0.44 (Grade III) to 0.66 (Grade I).
  • High reliability was observed among both experienced interventionalists (Kappa = 0.55) and junior fellows (Kappa = 0.65).

Conclusions:

  • The new classification scheme offers satisfactory interobserver reliability for spinal vascular malformations.
  • The system is robust, performing consistently even with less experienced raters and minimal training.
  • This scheme can be reliably used for consistent angiographic classification of spinal AVFs and AVMs.