为了评估读者对SAR-AGA建议的关键特征的共识，以解释和报告成人CD患者的MRE，重点关注放射科医师经验对CD表型读者共识的影响。
两名经验丰富的放射科医师和两名经验不足的放射科医师回顾性评估了99例CD患者的MRE（50例初始MRE，从2019年1月1日至2020年3月20日进行49次随访MRE），以治疗活动性肠道炎症（胃，近端小肠,回肠,结肠),狭窄,可能的狭窄，穿透性疾病，和肛周疾病。MRE方案不包括专用的肛周序列。使用患病率调整偏倚调整kappa确定每个成像特征的评分者之间的一致性，并通过经验水平进行比较。
所有读者对穿透性疾病都有近乎完美的读者间共识(κ>0.90)，脓肿,所有99例CD患者的肛周脓肿。在99例CD患者中，所有读者对回肠活动性炎症有很强的读者间共识（κ：0.80-0.90），近端小肠炎,和狭窄。经验不足的读者在初始回肠活动性炎症方面的读者之间的共识明显低于随访MRE（κ0.68对0.96，p=0.018），而在随访中狭窄方面的共识明显低于初始MRE（κ0.76对1.0，p=0.027）。有经验的读者在随访中对肛周瘘的一致性明显低于初始MRE（κ：0.55对0.92，p=0.008）。
对于SAR-AGA共识建议中描述的关键CD表型，包括回肠活动性和近端小肠炎，读者之间存在强烈到几乎完美的共识。狭窄,穿透性疾病，脓肿,和肛周脓肿.读者之间协议较低的领域可以作为未来教育工作的目标，以进一步标准化CDMRE报告。随访MRE时应包括专用的肛周序列。
To assess inter-reader agreement of key features from the SAR-AGA recommendations for the interpretation and reporting of
MRE in adult patients with CD, focusing on the impact of radiologist experience on inter-reader agreement of CD phenotypes.
Two experienced and two less-experienced radiologists retrospectively evaluated 99 MRE in CD patients (50 initial
MRE, 49 follow-up
MRE) performed from 1/1/2019 to 3/20/2020 for the presence of active bowel inflammation (stomach, proximal small bowel, ileum, colon), stricture, probable stricture, penetrating disease, and perianal disease. The
MRE protocol did not include dedicated perianal sequences. Inter-rater agreement was determined for each imaging feature using prevalence-adjusted bias-adjusted kappa and compared by experience level.
All readers had almost-perfect inter-reader agreement (κ > 0.90) for penetrating disease, abscess, and perianal abscess in all 99 CD patients. All readers had strong inter-reader agreement (κ: 0.80-0.90) in 99 CD patients for active ileum inflammation, proximal small bowel inflammation, and stricture. Less-experienced readers had significantly lower inter-reader agreement for active ileum inflammation on initial than follow-up MRE (κ 0.68 versus 0.96, p = 0.018) and for strictures on follow-up than initial MRE (κ 0.76 versus 1.0, p = 0.027). Experienced readers had significantly lower agreement for perianal fistula on follow-up than initial MRE (κ: 0.55 versus 0.92, p = 0.008).
There was strong to almost-perfect inter-reader agreement for key CD phenotypes described in the SAR-AGA
consensus recommendations including active ileum and proximal small bowel inflammation, stricture, penetrating disease, abscess, and perianal abscess. Areas of lower inter-reader agreement could be targeted for future education efforts to further standardize CD MRE reporting. Dedicated perianal sequences should be included on follow-up
MRE.
