Acute pancreatitis: Interobserver agreement and correlation of CT and MR cholangiopancreatography with outcome

PURPOSE: To assess the correlation between and the interobserver agreement of contrast medium-enhanced computed tomography (CT) and nonenhanced and co ntrast-enhanced magnetic resonance (MR) imaging findings in patients with a cute pancreatitis and to correlate these findings with outcome. MATERIALS AND METHODS: Two blinded reviewers separately assessed contrast-e nhanced CT and nonenhanced and contrast-enhanced MR images in 30 patients w ith acute pancreatitis and established a severity index based on the presen ce of peripancreatic fluid collections and pancreatic necrosis. The Spearma n rank correlation coefficient and weighted kappa statistic were used to as sess the correlation between each imaging technique and the interobserver a greement, respectively. Correlation between hospitalization days, morbidity , and severity indexes were assessed by using linear correlation. RESULTS: A strong correlation existed for both reviewers when Som pa ri ng contrast-enhanced CT with nonenhanced (r = 0.82, 0.79) or contrast-enhanced (r = 0.82, 0.79) MR cholangiopancreatography or when comparing nonenhanced and contrast-enhanced MR cholangiopancreatography (r = 0.99, 1.00). The in terobserver agreement in staging was,stronger with nonenhanced (kappa = 0.7 6) and contrast-enhanced (kappa = 0.78) MR cholangiopancreatography than wi th contrast-enhanced CT (kappa = 0.70). There was no linear correlation bet ween the severity index for contrast-enhanced CT and outcome, while there w as a linear correlation between nonenhanced or contrast-enhanced MR cholang iopancreatographic staging and the patient morbidity rate. CONCLUSION: MR cholangiopancreatography could be an alternative to contrast -enhanced CT for the initial staging of acute pancreatitis.