Low interrater reliability of brachial plexus MRI in chronic inflammatory neuropathies

Marieke H J van Rosmalen; H Stephan Goedee; Anouk van der Gijp; Theo D Witkamp; Martijn Froeling; Jeroen Hendrikse; W Ludo van der Pol

doi:10.1002/mus.26821

Low interrater reliability of brachial plexus MRI in chronic inflammatory neuropathies

Marieke H J van Rosmalen, H Stephan Goedee, Anouk van der Gijp, Theo D Witkamp, Martijn Froeling, Jeroen Hendrikse, W Ludo van der Pol

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Abstract

Introduction: Magnetic resonance imaging of the brachial plexus shows nerve thickening in approximately half of the patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). The reliability of qualitative evaluation of brachial plexus MRI has not been studied previously. Methods: We performed an interrater study in a retrospective cohort of 19 patients with CIDP, 17 patients with MMN, and 14 controls. The objective was to assess interrater variability between radiologists by using a predefined scoring system that allowed the distinction of no, possible, or definite nerve thickening. Results: Raters agreed in 26 of 50 (52%) brachial plexus images; κ-coefficient was 0.30 (SE 0.08, 95% confidence interval 0.14–0.46, P <.0005). Discussion: Our results provide evidence that interrater reliability of qualitative evaluation of brachial plexus MRI is low. Objective criteria for abnormality are required to optimize the diagnostic value of MRI for inflammatory neuropathies.

Original language	English
Pages (from-to)	779-783
Number of pages	5
Journal	Muscle & Nerve
Volume	61
Issue number	6
Early online date	3 Feb 2020
DOIs	https://doi.org/10.1002/mus.26821
Publication status	Published - 1 Jun 2020

Keywords

brachial plexus
chronic inflammatory demyelinating polyneuropathy
imaging
magnetic resonance imaging
multifocal motor neuropathy

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title = "Low interrater reliability of brachial plexus MRI in chronic inflammatory neuropathies",

abstract = "Introduction: Magnetic resonance imaging of the brachial plexus shows nerve thickening in approximately half of the patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). The reliability of qualitative evaluation of brachial plexus MRI has not been studied previously. Methods: We performed an interrater study in a retrospective cohort of 19 patients with CIDP, 17 patients with MMN, and 14 controls. The objective was to assess interrater variability between radiologists by using a predefined scoring system that allowed the distinction of no, possible, or definite nerve thickening. Results: Raters agreed in 26 of 50 (52%) brachial plexus images; κ-coefficient was 0.30 (SE 0.08, 95% confidence interval 0.14–0.46, P <.0005). Discussion: Our results provide evidence that interrater reliability of qualitative evaluation of brachial plexus MRI is low. Objective criteria for abnormality are required to optimize the diagnostic value of MRI for inflammatory neuropathies.",

keywords = "brachial plexus, chronic inflammatory demyelinating polyneuropathy, imaging, magnetic resonance imaging, multifocal motor neuropathy",

author = "{van Rosmalen}, {Marieke H J} and Goedee, {H Stephan} and {van der Gijp}, Anouk and Witkamp, {Theo D} and Martijn Froeling and Jeroen Hendrikse and {van der Pol}, {W Ludo}",

note = "Funding Information: Prinses Beatrix Spierfonds Publisher Copyright: {\textcopyright} 2020 The Authors. Muscle & Nerve published by Wiley Periodicals, Inc. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

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doi = "10.1002/mus.26821",

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AU - Goedee, H Stephan

AU - van der Gijp, Anouk

AU - Witkamp, Theo D

AU - Froeling, Martijn

AU - Hendrikse, Jeroen

AU - van der Pol, W Ludo

N1 - Funding Information: Prinses Beatrix Spierfonds Publisher Copyright: © 2020 The Authors. Muscle & Nerve published by Wiley Periodicals, Inc. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/6/1

Y1 - 2020/6/1

N2 - Introduction: Magnetic resonance imaging of the brachial plexus shows nerve thickening in approximately half of the patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). The reliability of qualitative evaluation of brachial plexus MRI has not been studied previously. Methods: We performed an interrater study in a retrospective cohort of 19 patients with CIDP, 17 patients with MMN, and 14 controls. The objective was to assess interrater variability between radiologists by using a predefined scoring system that allowed the distinction of no, possible, or definite nerve thickening. Results: Raters agreed in 26 of 50 (52%) brachial plexus images; κ-coefficient was 0.30 (SE 0.08, 95% confidence interval 0.14–0.46, P <.0005). Discussion: Our results provide evidence that interrater reliability of qualitative evaluation of brachial plexus MRI is low. Objective criteria for abnormality are required to optimize the diagnostic value of MRI for inflammatory neuropathies.

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Low interrater reliability of brachial plexus MRI in chronic inflammatory neuropathies

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