根据修订后的亚特兰大急性胰腺炎分类描述胰周积液：一项国际观察者间一致性研究

Describing Peripancreatic Collections According to the Revised Atlanta Classification of Acute Pancreatitis: An International Interobserver Agreement Study.

作者信息

Bouwense Stefan A, van Brunschot Sandra, van Santvoort Hjalmar C, Besselink Marc G, Bollen Thomas L, Bakker Olaf J, Banks Peter A, Boermeester Marja A, Cappendijk Vincent C, Carter Ross, Charnley Richard, van Eijck Casper H, Freeny Patrick C, Hermans John J, Hough David M, Johnson Colin D, Laméris Johan S, Lerch Markus M, Mayerle Julia, Mortele Koenraad J, Sarr Michael G, Stedman Brian, Vege Santhi Swaroop, Werner Jens, Dijkgraaf Marcel G, Gooszen Hein G, Horvath Karen D

机构信息

From the *Department of OR/Clinical Surgical Research, Radboud university medical center, Nijmegen; Departments of †Gastroenterology and Hepatology, and ‡Surgery, Academic Medical Center, Amsterdam; §Department of Radiology, St. Antonius Hospital, Nieuwegein; ∥Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; ¶Department of Gastroenterology, Center for Pancreatic Disease, Brigham and Women's Health Hospital, Harvard Medical School, Boston, MA; #Department of Radiology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands; **Department of Surgery, Glasgow Royal Infirmary, Glasgow; ††Department of Surgery, Freeman Hospital, Newcastle Upon Tyne, United Kingdom; ‡‡Department of Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands; §§Department of Radiology, University of Washington Medical Center, Seattle, WA; ∥∥Department of Radiology, Radboud university medical center, Nijmegen, The Netherlands; ¶¶Department of Radiology, Mayo Clinic, Rochester, MN; ##Department of Surgery, University Hospital Southampton, Hampshire, United Kingdom; ***Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; †††Department of Medicine A, University Medicine Greifswald, Germany; ‡‡‡Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA; §§§Department of Surgery, Mayo Clinic, Rochester, MN; ∥∥∥Department of Radiology, University Hospital Southampton, Hampshire, United Kingdom; ¶¶¶Department of Gastroenterology, Mayo Clinic, Rochester, MN; ###Department of Surgery, Ludwig Maximilian University of Munich, Munich, Germany; ****Department of Clinical Research Unit, Academic Medical Center, Amsterdam, The Netherlands; and ††††Department of Surgery, University of Washington Medical Center, Seattle, WA.

出版信息

Pancreas. 2017 Aug;46(7):850-857. doi: 10.1097/MPA.0000000000000863.

DOI:10.1097/MPA.0000000000000863

PMID:28697123

Abstract

OBJECTIVES

Severe acute pancreatitis is associated with peripancreatic morphologic changes as seen on imaging. Uniform communication regarding these morphologic findings is crucial for accurate diagnosis and treatment. For the original 1992 Atlanta classification, interobserver agreement is poor. We hypothesized that for the revised Atlanta classification, interobserver agreement will be better.

METHODS

An international, interobserver agreement study was performed among expert and nonexpert radiologists (n = 14), surgeons (n = 15), and gastroenterologists (n = 8). Representative computed tomographies of all stages of acute pancreatitis were selected from 55 patients and were assessed according to the revised Atlanta classification. The interobserver agreement was calculated among all reviewers and subgroups, that is, expert and nonexpert reviewers; interobserver agreement was defined as poor (≤0.20), fair (0.21-0.40), moderate (0.41-0.60), good (0.61-0.80), or very good (0.81-1.00).

RESULTS

Interobserver agreement among all reviewers was good (0.75 [standard deviation, 0.21]) for describing the type of acute pancreatitis and good (0.62 [standard deviation, 0.19]) for the type of peripancreatic collection. Expert radiologists showed the best and nonexpert clinicians the lowest interobserver agreement.

CONCLUSIONS

Interobserver agreement was good for the revised Atlanta classification, supporting the importance for widespread adaption of this revised classification for clinical and research communications.

摘要

目的

重症急性胰腺炎与影像学上所见的胰腺周围形态学改变相关。就这些形态学发现进行统一沟通对于准确诊断和治疗至关重要。对于1992年最初的亚特兰大分类，观察者间的一致性较差。我们假设对于修订后的亚特兰大分类，观察者间的一致性会更好。

方法

在专家和非专家放射科医生（n = 14）、外科医生（n = 15）和胃肠病学家（n = 8）之间进行了一项国际观察者间一致性研究。从55例患者中选取了急性胰腺炎各阶段具有代表性的计算机断层扫描图像，并根据修订后的亚特兰大分类进行评估。计算所有评审人员及亚组（即专家和非专家评审人员）之间的观察者间一致性；观察者间一致性被定义为差（≤0.20）、一般（0.21 - 0.40）、中等（0.41 - 0.60）、良好（0.61 - 0.80）或非常好（0.81 - 1.00）。