Reliability assessment of the upper urinary tract dilation grading system based on magnetic resonance urography in patients with neurogenic bladder

BMC Urol. 2022 Jul 4;22(1):97. doi: 10.1186/s12894-022-01039-y.

Abstract

Background: To assess the inter-observer and intra-observer reliability of the magnetic resonance urography (MRU)-upper urinary tract dilation (UUTD) grading system.

Methods: A total of 40 patients with a diagnosis of NB were enrolled in this study. The images were assembled in an electronic presentation randomly. The presentations were reviewed and graded by 4 junior and 4 senior urologists. One week later, the images were randomized again and reassessed. The inter-observer reliability was estimated by Kendall's coefficient of concordance and intra-class correlation coefficient (ICC), and the intra-observer reliability was estimated by weighted Cohen's kappa.

Results: The inter-observer reliability strength was excellent for all urologists, with the ICC value of 0.939 (0.908-0.963) and Kendall's W value of 0.967. The highest agreement was shown in Grade 4 at 92.50%, and the lowest in Grade 2 at 82.14%. All disagreements were within one grade of difference. Moreover, the Intra-observer reliability was excellent, with the weighted kappa value ranging from 0.904 to 0.954.

Conclusions: The inter-observer and intra-observer reliability of this novel MRU-UUTD grading system is confirmed, providing adequate evidence for broader clinical application.

Keywords: Magnetic resonance urography; Neurogenic bladder; Reliability; Upper urinary tract dilation.

MeSH terms

  • Dilatation
  • Humans
  • Magnetic Resonance Spectroscopy
  • Observer Variation
  • Reproducibility of Results
  • Urinary Bladder, Neurogenic* / diagnostic imaging
  • Urinary Tract* / diagnostic imaging
  • Urography / methods