Magnetic resonance cholangiopancreatography for suspected cholangiopathy in children and young adults: a multi-reader agreement study.

IF 2.1 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2025-03-01 Epub Date: 2025-02-04 DOI:10.1007/s00247-025-06173-x

Pradipta Debnath, Nadeen K Abu Ata, Joseph Y Cao, Shailee V Lala, Archana Malik, Erica L Riedesel, Gary R Schooler, Narendra S Shet, Leslie H Spence, A Luana Stanescu, Bin Zhang, Jean A Tkach, Leticia Khendek, Alexander G Miethke, Andrew T Trout, Jonathan R Dillman

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引用次数: 0

Abstract

Background: Magnetic resonance cholangiopancreatography (MRCP) is used to diagnose and monitor primary sclerosing cholangitis (PSC).

Objective: To assess inter-reader agreement for the diagnosis of PSC/autoimmune sclerosing cholangitis (ASC) and for individual MRCP features of cholangiopathy in a pediatric sample.

Materials and methods: This was a retrospective, IRB-approved study that included MRCP examinations from patients <21 years old with known or suspected cholangiopathy. Multiple biliary and hepatic imaging features were assessed independently by nine pediatric radiologists using 2D and 3D MRCP images. Kappa (κ) statistics and intra-class correlation coefficients (ICC) with 95% confidence intervals (CI) were used to measure inter-reader agreement.

Results: Seventy-five patients were included (median age=16.8 [IQR 13.8-18.7] years; 48 boys); 22.7% (17/75) had PSC, 22.7% (17/75) had ASC, and 54.7% (41/75) had other diagnoses. Among observers, agreement was only slight for presence of cholangiopathy (κ=0.15 [95% CI 0.07 to 0.23]) and presence of PSC/ASC (κ=0.13 [0.06 to 0.21]). Agreement was poor for categorical intrahepatic stricture number (κ=-0.002 [(-0.16 to 0.15]) and stricture extent (κ=-0.06 [-0.09 to-0.02]). Agreement was slight for presence of intrahepatic stricturing disease (κ=0.08 [0.04 to 0.12]). Most other findings had fair agreement between readers (including intrahepatic focal dilations, intrahepatic and extrahepatic diverticula, diffuse extrahepatic dilation without stricture, bile duct mural thickening, and biliary obstruction [κ=0.22 to 0.34]). There was moderate agreement for categorical extrahepatic stricture length (κ=0.46 [-0.11 to 1]) and presence of extrahepatic biliary dilation (κ=0.53 [0.40 to 0.65]). There was excellent agreement for extrahepatic bile duct maximum diameter (ICC=0.89 [0.85 to 0.92]).

Conclusion: Inter-reader agreement for interpreting MRCP in children and young adults is slight to fair for the diagnosis of PSC/ASC and for most findings of cholangiopathy.

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磁共振胆管造影对儿童和年轻人疑似胆管病的诊断：一项多读者协议研究。

背景：磁共振胆管造影（MRCP）用于诊断和监测原发性硬化性胆管炎（PSC）。目的：评估儿童样本中PSC/自身免疫性硬化性胆管炎（ASC）诊断的读者间一致性以及胆管病的个体MRCP特征。材料和方法：这是一项经irb批准的回顾性研究，纳入了患者的MRCP检查结果：纳入了75例患者(中位年龄=16.8 [IQR 13.8-18.7]岁；48个男孩);22.7%（17/75）有PSC， 22.7%（17/75）有ASC， 54.7%（41/75）有其他诊断。在观察者中，存在胆管病变（κ=0.15 [95% CI 0.07至0.23]）和存在PSC/ASC （κ=0.13[0.06至0.21]）的一致性较低。肝内狭窄分类数(κ=-0.002[（-0.16 ~ 0.15]）和狭窄程度（κ=-0.06[-0.09 ~ 0.02]）的一致性较差。存在肝内狭窄性疾病的一致性较低（κ=0.08[0.04 ~ 0.12]）。大多数其他发现在读者之间具有相当的一致性（包括肝内局灶性扩张、肝内和肝外憩室、无狭窄的弥漫性肝外扩张、胆管壁增厚和胆道梗阻[κ=0.22至0.34]）。肝外狭窄的分类长度（κ=0.46[-0.11 ~ 1]）和肝外胆道扩张的存在（κ=0.53[0.40 ~ 0.65]）有中度一致性。肝外胆管最大直径的一致性非常好（ICC=0.89[0.85 ~ 0.92]）。结论：对于PSC/ASC的诊断和大多数胆管病的发现，解读儿童和年轻人MRCP的读者间一致性是轻微或公平的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.