Sipola Petri, Leinonen Ville, Niemeläinen Riikka, Aalto Timo, Vanninen Ritva, Manninen Hannu, Airaksinen Olavi, Battié Michele C
University of Eastern Finland, School of Medicine, Institute of Clinical Medicine, Department of Clinical Radiology, Kuopio, Finland.
Acta Radiol. 2011 Nov 1;52(9):1024-31. doi: 10.1258/ar.2011.110083. Epub 2011 Oct 3.
Lateral lumbar spinal canal stenosis is a common etiology of lumbar radicular symptoms. Quantitative measurements have commonly demonstrated better repeatability than visual assessments. We are not aware of any studies examining the repeatability of quantitative assessment of the lateral canal.
To evaluate the repeatability of visual assessments and newly developed quantitative measurements of lateral lumbar spinal canal stenosis using magnetic resonance imaging (MRI).
Twenty-eight patients with lateral lumbar spinal canal stenosis or prior spinal surgery with recurrent symptoms were imaged with MRI. A radiologist, a neurosurgeon and a spine research trainee graded visually and quantitatively subarticular (n = 188) and foraminal zones (n = 260) of the lateral spinal canal. Quantitative measurements included the minimal subarticular width and the cross-sectional area of the foramen.
The repeatability of visual assessment at the subarticular zone and foraminal zones between raters varied from 0.45-0.59 and 0.42-0.53, respectively. Similarly, the intraclass correlation coefficients for the quantitative measurements varied from 0.67-0.71 and 0.66-0.76, respectively. The intra-rater repeatability for the visual assessments of the subarticular and foraminal zones was 0.70 and 0.62, respectively, while the corresponding intraclass correlation coefficients for quantitative measurements were 0.83 and 0.81, respectively.
Inter-rater repeatability of visual assessments of lateral stenosis is moderate, whereas quantitative measurements of both subarticular width and the cross-sectional area of the foramen have substantial reproducibility and may be particularly useful for longitudinal studies and research purposes. The clinical value of these parameters requires further study.
侧隐窝型腰椎管狭窄症是导致腰神经根症状的常见病因。定量测量通常显示出比视觉评估更好的可重复性。我们尚未发现有任何研究对侧隐窝定量评估的可重复性进行过检测。
利用磁共振成像（MRI）评估侧隐窝型腰椎管狭窄症视觉评估和新开发的定量测量方法的可重复性。
对28例患有侧隐窝型腰椎管狭窄症或既往有脊柱手术史且症状复发的患者进行MRI检查。一名放射科医生、一名神经外科医生和一名脊柱研究实习生对侧椎管的关节下区域（n = 188）和椎间孔区域（n = 260）进行视觉和定量分级。定量测量包括关节下最小宽度和椎间孔横截面积。
评估者之间在关节下区域和椎间孔区域的视觉评估可重复性分别为0.45 - 0.59和0.42 - 0.53。同样，定量测量的组内相关系数分别为0.67 - 0.71和0.66 - 0.76。关节下区域和椎间孔区域视觉评估的评估者内可重复性分别为0.70和0.62，而定量测量的相应组内相关系数分别为0.83和0.81。
侧隐窝狭窄视觉评估的评估者间可重复性为中等，而关节下宽度和椎间孔横截面积的定量测量具有较高的可重复性，可能对纵向研究和研究目的特别有用。这些参数的临床价值需要进一步研究。
