新的颈椎管狭窄症 MRI 分级系统。

New MRI grading system for the cervical canal stenosis.

机构信息

Department of Radiology, Seoul National University Bundang Hospital, Bundag-Gu, Seong Nam, Gyeongi-do, Republic of Korea.

出版信息

AJR Am J Roentgenol. 2011 Jul;197(1):W134-40. doi: 10.2214/AJR.10.5560.

DOI:10.2214/AJR.10.5560

PMID:21700974

Abstract

OBJECTIVE

The purpose of this study was to propose a new MRI grading system for cervical canal stenosis and to evaluate the reproducibility of the system.

MATERIALS AND METHODS

Cervical canal stenosis was classified according to the T2-weighted sagittal images into the following grades: grade 0, absence of canal stenosis; grade 1, subarachnoid space obliteration exceeding 50%; grade 2, spinal cord deformity; and grade 3, spinal cord signal change. The MRI scans of 82 patients (37 men and 45 women; mean age, 65.2 years; range, 60-86 years) were independently analyzed by six radiologists. Interobserver and intraobserver agreements were analyzed using intraclass correlation coefficient (ICC), along with the percentage agreement and kappa statistics.

RESULTS

The ICC for interobserver agreement was 0.716-0.802, indicating good-to-excellent agreement. For the distinction among the four grades, the percentage of agreement was 63-64% (κ = 0.60-0.62). The percentage of agreement for the presence of cervical canal stenosis (grade 0 vs grades 1, 2, and 3) was 79-85% (κ = 0.51-0.59). The percentage of agreement for insignificant (grade 0-1) or significant (grade 2-3) stenosis was 81-85% (κ = 0.57-0.66). The percentage of agreement for the presence of spinal cord signal change (grade 0-2 vs grade 3) was 92-95% (κ = 0.70-0.73). The overall intraobserver agreement was excellent, as determined by an ICC of 0.768.

CONCLUSION

The new grading system provides a reliable assessment of cervical canal stenosis.

摘要

目的

本研究旨在提出一种新的颈椎管狭窄磁共振成像（MRI）分级系统，并评估该系统的可重复性。

材料与方法

根据 T2 加权矢状位图像，颈椎管狭窄分为以下等级：0 级，无椎管狭窄；1 级，蛛网膜下腔消失超过 50%；2 级，脊髓变形；3 级，脊髓信号改变。由 6 名放射科医生对 82 例患者（37 名男性和 45 名女性；平均年龄 65.2 岁；范围 60-86 岁）的 MRI 扫描结果进行独立分析。采用组内相关系数（ICC）评估观察者间和观察者内的一致性，并结合百分比一致性和 Kappa 统计评估。

结果

观察者间一致性的 ICC 为 0.716-0.802，表明一致性较好至极好。对于 4 个等级的区分，一致性百分比为 63-64%（Kappa = 0.60-0.62）。颈椎管狭窄（0 级与 1、2、3 级）存在的一致性百分比为 79-85%（Kappa = 0.51-0.59）。无意义狭窄（0-1 级）或显著狭窄（2-3 级）的一致性百分比为 81-85%（Kappa = 0.57-0.66）。脊髓信号改变（0-2 级与 3 级）存在的一致性百分比为 92-95%（Kappa = 0.70-0.73）。观察者内总体一致性极好，ICC 为 0.768。