Abstract
Objectives
This study evaluates the inter- and intrarater reliability of the Manjila and Semaan
classification system for the anatomical position of the jugular bulb. The classification
system, proposed in 2018, aims to address inconsistencies in reporting that impact
communication between radiologists and skull base surgeons and affect surgical planning.
Design
Bilateral jugular bulb positions on 50 consecutive computed tomography (CT) venography
examinations were assessed by two neuroradiology attending physicians, two neuroradiology
fellows, and two radiology residents.
Setting
The study was conducted in a clinical radiology setting on an Ambra PACS workstation.
Participants
Consecutive patients who underwent clinical CT venography examinations between August
3, 2021, and January 29, 2022, and met the inclusion criteria were included in the
analysis.
Main Outcome Measures
Inter- and intrarater reliability were assessed using kappa values, Kendall's coefficient
of concordance (W), and Spearman's rho.
Results
Interrater agreement, measured by kappa values, showed moderate to substantial agreement
for bilateral jugular bulb position types. Kendall's W indicated substantial to almost-perfect interrater agreement. Intrarater agreement
was almost perfect according to kappa values and was high in monotonicity, as indicated
by Spearman's rho.
Conclusion
The Manjila and Semaan classification system demonstrated high inter- and intrarater
reliability across a spectrum of experience levels. Adopting this classification could
enhance clinical communication and improve surgical planning.
Keywords
high-riding jugular bulb - internal auditory canal - jugular bulb anatomy - jugular
dehiscence - jugular diverticulum - pulsatile tinnitus - semicircular canal - skull
base
