Low interrater reliability of brachial plexus MRI in chronic inflammatory neuropathies

Muscle Nerve. 2020 Jun;61(6):779-783. doi: 10.1002/mus.26821. Epub 2020 Feb 21.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brachial Plexus / diagnostic imaging*
  • Brachial Plexus / physiopathology*
  • Brachial Plexus Neuropathies / diagnostic imaging
  • Brachial Plexus Neuropathies / physiopathology
  • Cohort Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / standards*
  • Male
  • Middle Aged
  • Observer Variation
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnostic imaging*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / physiopathology*
  • Reproducibility of Results
  • Retrospective Studies