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Erschienen in:
17.08.2018
Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease
Erschienen in: Abdominal Radiology | Ausgabe 2/2019
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Purpose
To assess inter-radiologist agreement using the Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus recommendations for reporting CT/MR enterography exams in pediatric and young adult small bowel Crohn disease (CD).
Methods
Institutional review board approval was obtained for this HIPAA-compliant retrospective investigation; the requirement for informed consent was waived. 25 CT and 25 MR enterography exams performed in children and young adults (age range: 6–23 years) between January 2015 and April 2017 with a distribution of ileal CD severity (phenotype) were identified: normal or chronic CD without active inflammation (40%), active inflammatory CD (20%), stricturing CD (20%), and penetrating CD (20%). Five fellowship-trained pediatric radiologists, blinded to one another, documented key imaging findings and standardized impressions based on SAR-AGA consensus recommendations. Inter-radiologist agreement was evaluated using Fleiss’ multi-rater kappa statistic (κ) with 95% confidence intervals (CI).
Results
Inter-radiologist agreement was moderate for all key imaging findings except presence of ulcerations (κ 0.37 [95% CI 0.28–0.46]) and sacculations (κ 0.31 [95% CI 0.23–0.40]). Agreement for standardized impressions was substantial for stricturing disease (κ 0.79 [95% CI 0.70–0.87]) and moderate for presence of inflammation (κ 0.49 [95% CI 0.44–0.56]) and penetrating disease (κ 0.58 [95% CI 0.49–0.67]). No significant difference in agreement was found between CT and MRI.
Conclusions
Agreement among five pediatric radiologists was moderate to substantial for SAR-AGA standardized impressions and fair to moderate for key imaging findings of pediatric and young adult CD.