Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm, Sweden.
Department of Abdominal Radiology, Karolinska University Hospital, Stockholm, Sweden.
Scand J Gastroenterol. 2020 Feb;55(2):228-235. doi: 10.1080/00365521.2020.1720281. Epub 2020 Feb 5.
Interpretation of MRI/MRCP in primary sclerosing cholangitis (PSC) at a single time point has low inter-reader agreement. Agreement of interpretation of the dynamic course of duct changes in follow-up MRI/MRCP is of clinical importance but remains unknown. Our aims are therefore to assess the inter-reader agreement of interpretation of the course of duct changes in PSC and investigate if elimination of 3 D MRCP affects inter-reader agreement. We studied 40 consecutive PSC-patients who underwent two liver MRI/MRCPs at two time points. Two readers independently evaluated the course of duct changes between the two time points in two imaging sets, one with and one without 3 D MRCP. The intraclass correlation coefficient (ICC) was calculated for evaluation of inter-reader and intra-reader agreement between the two time points and two imaging sets accordingly. Inter-reader agreement of the interpretation of the course of duct changes between the two time points was poor (ICC up to 0.224). Elimination of 3 D MRCP neither improved inter-reader agreement which was again poor (ICC up to 0.26) nor did it change considerably the way readers interpret the course of ducts changes (ICC for intra-reader agreement between 0.809 and 0.978). Inter-reader agreement of the interpretation of radiological course of duct changes is poor in serial follow-up MRI/MRCP of PSC-patients. Elimination of 3 D MRCP does not increase inter-reader agreement but maintains an excellent intra-reader agreement for the interpretation of the dynamic course of bile duct changes.Key pointsInter-reader agreement of interpretation of radiological course of bile duct changes between serial follow-up MRI/MRCP examinations of patients with PSC is poor.Absence of 3D MRCP does not affect considerably the way readers interpret the radiological course of bile ducts changes.When MRCP is absent or of low quality, utilization of other sequences seems to be helpful as an alternative for bile duct evaluation.
在单个时间点对原发性硬化性胆管炎 (PSC) 进行 MRI/MRCP 解读的观察者间一致性较低。在随访 MRI/MRCP 中动态胆管变化过程的解读的观察者间一致性具有临床重要性，但尚不清楚。因此，我们的目的是评估 PSC 胆管变化过程的解读的观察者间一致性，并研究消除 3D MRCP 是否会影响观察者间一致性。我们研究了 40 例连续的 PSC 患者，他们在两个时间点进行了两次肝脏 MRI/MRCP。两名观察者独立评估了两次成像时间点之间胆管变化的过程，一次成像有 3D MRCP，一次成像没有 3D MRCP。计算了观察者间和观察者内两次成像时间点和两次成像组之间的内类相关系数 (ICC)，以评估观察者间和观察者内的一致性。两次成像时间点之间胆管变化过程的解读的观察者间一致性较差（ICC 最高可达 0.224）。消除 3D MRCP 并没有改善观察者间一致性（ICC 最高可达 0.26），也没有显著改变观察者解读胆管变化过程的方式（观察者内一致性的 ICC 为 0.809 至 0.978）。PSC 患者连续随访 MRI/MRCP 中胆管变化的影像学解读的观察者间一致性较差。消除 3D MRCP 不会增加观察者间一致性，但对动态胆管变化过程的解读保持了极好的观察者内一致性。
在 PSC 患者的连续随访 MRI/MRCP 检查中，对胆管影像学变化过程的解读的观察者间一致性较差。
缺乏 3D MRCP 并不会显著影响观察者解读胆管变化的方式。
在 MRCP 缺失或质量较低的情况下，利用其他序列似乎有助于替代胆管评估。
