Related Experiment Video
Updated: Mar 12, 2026
Author Spotlight: Bridging Gaps in Anatomy and Establishing a Foundation for Algorithmic Studies
Published on: December 15, 2023
Inter- and Intrarater Reliability of the Manjila and Semaan Classification System when Assessing Jugular Bulb
Michelle L Hunt1, Carson K Smith2, Austin Svec3
1Department of Neuroradiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States.
The Manjila and Semaan classification system for jugular bulb anatomy shows high reliability among radiologists. This system can improve communication and surgical planning for skull base procedures.
Area of Science:
- Radiology
- Anatomy
- Neurosurgery
Background:
- Inconsistent reporting of jugular bulb anatomy complicates communication between radiologists and skull base surgeons.
- Accurate anatomical classification is crucial for effective surgical planning.
Purpose of the Study:
- To evaluate the inter- and intrarater reliability of the Manjila and Semaan classification system for jugular bulb anatomical position.
- To assess the system's utility in improving diagnostic consistency.
Main Methods:
- Two neuroradiology attending physicians, two fellows, and two residents assessed bilateral jugular bulb positions on 50 CT venography exams.
- Inter- and intrarater reliability were measured using kappa values, Kendall's W, and Spearman's rho.
Main Results:
- Kappa values indicated moderate to substantial interrater agreement for jugular bulb position types.
- Kendall's W showed substantial to almost-perfect interrater agreement.
- Intrarater agreement was almost perfect by kappa values and high in monotonicity (Spearman's rho).
Conclusions:
- The Manjila and Semaan classification system demonstrates high inter- and intrarater reliability across experience levels.
- Adoption of this system can enhance clinical communication and surgical planning for skull base interventions.
Related Concept Videos
01:23Assessment of blood pressure in brachial artery(two-step method)
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...