Intraobserver and interobserver agreement for identifying extraluminal manifestations of Crohn's disease with magnetic resonance enterography

Summary Background Magnetic resonance (MR) enterography has emerged as a new imaging modality in evaluating patients with Crohn's disease. However, whether interpretations of MR enterography findings are consistent among radiologists has not yet been fully investigated. The purpose of this study is to evaluate the intraobserver and interobserver agreement for identifying extraluminal manifestations of Crohn's disease with MR enterography. Methods MR enterography was performed with a 3-tesla system. We retrospectively enrolled patients with Crohn's disease that had MR enterography between November 2011 and March 2013. Three radiologists reviewed the images independently. Extraluminal findings of these patients were recorded and described. Intraobserver and interobserver agreement were calculated using the kappa statistic. Results A total of 22 sessions of MR enterography were performed on 15 patients (12 men and 3 women) with Crohn's disease. The mean age was 38.7 ± 11.4 years. We identified extraluminal manifestations such as engorged vasa recta, enlarged mesenteric lymph nodes, fibrofatty proliferation, fistulas, and abscesses. In addition, avascular necrosis of the femoral head as a complication of long-term steroid treatment was also depicted. The intraobserver agreement was almost perfect (κ = 0.83; p p Conclusion MR enterography is a clinically useful tool for evaluating extraluminal manifestations of Crohn's disease with good intraobserver and interobserver agreement.