Abdominal Radiology

, Volume 44, Issue 2, pp 391–397 | Cite as

Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease

  • Mitchell A. ReesEmail author
  • Jonathan R. Dillman
  • Christopher G. Anton
  • Mantosh S. Rattan
  • Ethan A. Smith
  • Alexander J. Towbin
  • Bin Zhang
  • Andrew T. Trout



To assess inter-radiologist agreement using the Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus recommendations for reporting CT/MR enterography exams in pediatric and young adult small bowel Crohn disease (CD).


Institutional review board approval was obtained for this HIPAA-compliant retrospective investigation; the requirement for informed consent was waived. 25 CT and 25 MR enterography exams performed in children and young adults (age range: 6–23 years) between January 2015 and April 2017 with a distribution of ileal CD severity (phenotype) were identified: normal or chronic CD without active inflammation (40%), active inflammatory CD (20%), stricturing CD (20%), and penetrating CD (20%). Five fellowship-trained pediatric radiologists, blinded to one another, documented key imaging findings and standardized impressions based on SAR-AGA consensus recommendations. Inter-radiologist agreement was evaluated using Fleiss’ multi-rater kappa statistic (κ) with 95% confidence intervals (CI).


Inter-radiologist agreement was moderate for all key imaging findings except presence of ulcerations (κ 0.37 [95% CI 0.28–0.46]) and sacculations (κ 0.31 [95% CI 0.23–0.40]). Agreement for standardized impressions was substantial for stricturing disease (κ 0.79 [95% CI 0.70–0.87]) and moderate for presence of inflammation (κ 0.49 [95% CI 0.44–0.56]) and penetrating disease (κ 0.58 [95% CI 0.49–0.67]). No significant difference in agreement was found between CT and MRI.


Agreement among five pediatric radiologists was moderate to substantial for SAR-AGA standardized impressions and fair to moderate for key imaging findings of pediatric and young adult CD.


Inflammatory bowel disease Crohn disease Enterography Pediatric Standardized reporting Inter-reader agreement 


Compliance with ethical standards


This study was not funded.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

The requirement for informed consent was waived by the institutional review board.

Supplementary material

261_2018_1743_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Division of Biostatistics and EpidemiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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