Besselink Marc G H, van Santvoort Hjalmar C, Bollen Thomas L, van Leeuwen Maarten S, Laméris Jan S, van der Jagt Eric J, Strijk Simon P, Buskens Erik, Freeny Patrick C, Gooszen Hein G
Department of Surgery, University Medical Center Utrecht, The Netherlands.
Pancreas. 2006 Nov;33(4):331-5. doi: 10.1097/01.mpa.0000240598.88193.8e.
The 1992 Atlanta classification is a clinically based classification system that defines the severity and complications of acute pancreatitis. A study was undertaken to assess the interobserver agreement of categorizing peripancreatic collections on computed tomography (CT) using the Atlanta classification.
Preoperative contrast-enhanced CTs from 70 consecutive patients (49 men; median age, 59 years; range, 29-79 years) operated for acute necrotizing pancreatitis (2000-2003) in 11 hospitals were reviewed. Five abdominal radiologists independently categorized the peripancreatic collections according to the Atlanta classification. Radiologists were aware of the timing of the CT and the clinical condition of the patient. Interobserver agreement was determined.
Interobserver agreement among the radiologists was poor (kappa, 0.144; SD, 0.095). In 3 (4%) of 70 cases, the same Atlanta definition was chosen. In 13 (19%) of 70 cases, 4 radiologists agreed, and in 42 (60%) of 70 cases, 3 radiologists agreed on the definition. In 21 cases (30%), 1 or more of the radiologists classified a collection as "pancreatic abscess," whereas 1 or more radiologist used another Atlanta definition.
The interobserver agreement of the Atlanta classification for categorizing peripancreatic collections in acute pancreatitis on CT is poor. The Atlanta classification should not be used to describe complications of acute pancreatitis on CT.
1992年亚特兰大分类法是一种基于临床的分类系统，用于定义急性胰腺炎的严重程度和并发症。本研究旨在评估使用亚特兰大分类法对计算机断层扫描（CT）上胰周积液进行分类时观察者间的一致性。
回顾了11家医院2000年至2003年因急性坏死性胰腺炎接受手术的70例连续患者（49例男性；中位年龄59岁；范围29 - 79岁）的术前增强CT。五名腹部放射科医生根据亚特兰大分类法对胰周积液进行独立分类。放射科医生知晓CT检查时间和患者的临床状况。确定观察者间的一致性。
放射科医生之间的观察者间一致性较差（kappa值为0.144；标准差为0.095）。在70例病例中的3例（4%），选择了相同的亚特兰大定义。在70例病例中的13例（19%），4名放射科医生意见一致，在70例病例中的42例（60%），3名放射科医生对定义达成一致。在21例病例（30%）中，1名或多名放射科医生将一处积液分类为“胰腺脓肿”，而1名或多名放射科医生使用了另一种亚特兰大定义。
亚特兰大分类法对急性胰腺炎CT上胰周积液进行分类时观察者间的一致性较差。不应使用亚特兰大分类法来描述急性胰腺炎CT上的并发症。
