Stafira Jeffrey S, Sonnad Jagadeesh R, Yuh William T C, Huard David R, Acker Robin E, Nguyen Dan L, Maley Joan E, Ramji Faridali G, Li Wen-Bin, Loftus Christopher M
Department of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
AJNR Am J Neuroradiol. 2003 Apr;24(4):766-9.
Several studies have been undertaken to validate quantitative methods of evaluating cervical spinal stenosis. This study was performed to assess the degree of interobserver and intraobserver agreement in the qualitative evaluation of cervical spinal stenosis on CT myelograms and MR images.
Cervical MR images and CT myelograms of 38 patients were evaluated retrospectively. Six neuroradiologists with various backgrounds and training independently assessed the level, degree, and cause of stenosis on either MR images or CT myelograms. Unknown to the evaluators, 16 of the patients were evaluated twice to determine intraobserver variability.
Interobserver agreement among the radiologists with regard to level, degree, and cause of stenosis on CT myelograms showed kappa values of 0.50, 0.26, and 0.32, respectively, and on MR images showed kappa values of 0.60, 0.31, and 0.22, respectively. Intraobserver agreement with regard to level, degree, and cause of stenosis on CT myelograms showed mean kappa values of 0.69, 0.41, and 0.55, respectively, and on MR images showed mean kappa values of 0.80, 0.37, and 0.40, respectively.
MR imaging and CT myelographic evaluation of cervical spinal stenosis by using current qualitative methods results in significant variation in image interpretation.
已经开展了多项研究来验证评估颈椎管狭窄的定量方法。本研究旨在评估在CT脊髓造影和磁共振成像(MRI)上对颈椎管狭窄进行定性评估时,观察者间和观察者内的一致性程度。
对38例患者的颈椎MRI图像和CT脊髓造影进行回顾性评估。6名具有不同背景和培训经历的神经放射科医生分别独立地在MRI图像或CT脊髓造影上评估狭窄的水平、程度和病因。评估者不知情的是,其中16例患者接受了两次评估以确定观察者内变异性。
放射科医生在CT脊髓造影上关于狭窄水平、程度和病因的观察者间一致性的kappa值分别为0.50、0.26和0.32,在MRI图像上分别为0.60、0.31和0.22。在CT脊髓造影上关于狭窄水平、程度和病因的观察者内一致性的平均kappa值分别为0.69、0.41和0.55,在MRI图像上分别为0.80、0.37和0.40。
采用当前的定性方法对颈椎管狭窄进行MRI成像和CT脊髓造影评估时,图像解读存在显著差异。