{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:16:14Z","timestamp":1784297774021,"version":"3.55.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>The Heidelberg Bleeding Classification, developed for computed tomography, is also frequently used to classify intracranial hemorrhage (ICH) on magnetic resonance imaging. Additionally, the presence of any ICH is frequently used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. We assessed the interobserver agreement on the presence of any ICH and the type of ICH according to the Heidelberg Bleeding Classification on magnetic resonance imaging in patients treated with reperfusion therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We used 300 magnetic resonance imaging scans including susceptibility-weighted imaging or T2*-weighted gradient echo imaging of ischemic stroke patients within 1 week after reperfusion therapy. Six observers, blinded to clinical characteristics except for suspected location of the infarction, independently rated ICH according to the Heidelberg Bleeding Classification in random pairs. Percent agreement and Cohen\u2019s kappa (\u03ba) were estimated for the presence of any ICH (yes\/no), and for agreement on the Heidelberg Bleeding Classification class 1 and 2. For the Heidelberg Bleeding Classification class 1 and 2, weighted \u03ba was estimated to take the degree of disagreement into account.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>In 297 of 300 scans, the quality of scans was sufficient to score ICH. Observers agreed on the presence or absence of any ICH in 264 of 297 scans (88.9%; \u03ba 0.78 [95% CI, 0.71\u20130.85]). There was agreement on the Heidelberg Bleeding Classification class 1 and 2 and no ICH in class 1 and 2 in 226 of 297 scans (76.1%; \u03ba 0.63 [95% CI, 0.56\u20130.69]; weighted \u03ba 0.90 [95% CI, 0.87\u20130.93]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The presence of any ICH can be reliably scored on magnetic resonance imaging and can, therefore, be used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. Agreement of ICH types according to the Heidelberg Bleeding Classification is substantial and disagreements are small.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.122.042145","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T09:00:19Z","timestamp":1683536419000},"page":"1587-1592","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Interobserver Agreement on Intracranial Hemorrhage on Magnetic Resonance Imaging in Patients With Ischemic Stroke"],"prefix":"10.1161","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4681-8388","authenticated-orcid":true,"given":"Nadinda A.M.","family":"van der Ende","sequence":"first","affiliation":[{"name":"Departments of Neurology (N.A.M.v.d.E., S.P.R.L., B.R., D.W.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands."},{"name":"Radiology and Nuclear Medicine (N.A.M.v.d.E., S.P.R.L., S.A.C., A.M.G.v.H., B.R., A.v.d.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6905-3296","authenticated-orcid":true,"given":"Sven P.R.","family":"Luijten","sequence":"additional","affiliation":[{"name":"Departments of Neurology (N.A.M.v.d.E., S.P.R.L., B.R., D.W.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands."},{"name":"Radiology and Nuclear Medicine (N.A.M.v.d.E., S.P.R.L., S.A.C., A.M.G.v.H., B.R., A.v.d.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7172-8179","authenticated-orcid":true,"given":"Leo","family":"Kluijtmans","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Isala, Zwolle, the Netherlands (L.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1116-054X","authenticated-orcid":true,"given":"Alida A.","family":"Postma","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Maastricht University Medical Center and School for Mental Health and Sciences (Mhens), the Netherlands (A.A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0332-2158","authenticated-orcid":true,"given":"Sandra A.","family":"Cornelissen","sequence":"additional","affiliation":[{"name":"Radiology and Nuclear Medicine (N.A.M.v.d.E., S.P.R.L., S.A.C., A.M.G.v.H., B.R., A.v.d.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonius M.G.","family":"van Hattem","sequence":"additional","affiliation":[{"name":"Radiology and Nuclear Medicine (N.A.M.v.d.E., S.P.R.L., S.A.C., A.M.G.v.H., B.R., A.v.d.L.), Erasmus MC University Medical Center, Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert J.","family":"Lycklama \u00e0 Nijeholt","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Haaglanden MC, The Hague, the Netherlands (G.J.L.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6130-7311","authenticated-orcid":true,"given":"Reinoud P.H.","family":"Bokkers","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Medical Imaging Center, University Medical Center Groningen, University of Groningen, the Netherlands (R.P.H.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6532-2591","authenticated-orcid":true,"given":"Lars","family":"Thomassen","sequence":"additional","affiliation":[{"name":"Departments of Neurology (L.T., U.W.-A.), Center for Neurovascular Diseases, Haukeland University Hospital, Bergen, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3240-6040","authenticated-orcid":true,"given":"Ulrike","family":"Waje-Andreassen","sequence":"additional","affiliation":[{"name":"Departments of Neurology (L.T., U.W.-A.), Center for Neurovascular Diseases, Haukeland University Hospital, Bergen, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Logallo","sequence":"additional","affiliation":[{"name":"Neurosurgery (N.L.), Center for Neurovascular Diseases, Haukeland University Hospital, Bergen, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Bracard","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nancy, France (S.B., B.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-4464","authenticated-orcid":true,"given":"Benjamin","family":"Gory","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nancy, France (S.B., B.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8320-8303","authenticated-orcid":true,"given":"Bob","family":"Roozenbeek","sequence":"additional","affiliation":[{"name":"Departments of Neurology (N.A.M.v.d.E., S.P.R.L., B.R., D.W.J.D.), Erasmus MC University Medical Center, Rotterdam, the Netherlands."},{"name":"Radiology and Nuclear Medicine (N.A.M.v.d.E., S.P.R.L., S.A.C., A.M.G.v.H., B.R., A.v.d.L.), Erasmus MC University Medical Center, Rotterdam, the 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