Winklhofer Sebastian, Held Ulrike, Burgstaller Jakob M, Finkenstaedt Tim, Bolog Nicolae, Ulrich Nils, Steurer Johann, Andreisek Gustav, Del Grande Filippo
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, USA.
Eur Spine J. 2017 Feb;26(2):353-361. doi: 10.1007/s00586-016-4667-1. Epub 2016 Jun 22.
To assess the inter- and intra-reader agreement of commonly used quantitative and qualitative image parameters for the assessment of degenerative lumbar spinal canal stenosis (LSS) by magnetic resonance imaging (MRI).
In this ethical board approved cross-sectional multicenter study, MRI of 100 randomly selected patients (median age 72.5 years, 48 % female) of the prospective Lumbar Stenosis Outcome Study (LSOS) were evaluated by two independent readers. A set of five previously published core imaging parameters as well as nine qualitative and five quantitative additional parameters regarding LSS and degenerative changes of the lumbar spine were assessed to calculate κ and intraclass correlation coefficients (ICC) for the inter-reader agreement. Additional repeated image evaluations were performed by one reader to calculate the intra-reader agreement.
κ values for the core image parameters ranged between 0.42 (compromise of the foraminal zone) and 0.77 (relation between fluid and cauda equina) for inter-reader agreement and between 0.59 (compromise of the foraminal zone) and 0.8 (compromise of the central zone) for intra-reader agreement. The inter-reader agreement for the non-core parameters showed κ values of 0.27-0.69 and ICC values of 0.46-0.85. The intra-reader agreement showed κ values of 0.53-0.69 and ICC values of 0.81-0.88.
The inter- and intra-reader agreement of commonly used quantitative and qualitative image parameters for the assessment of LSS showed quite a variability with previously defined core parameters having good to excellent inter- and intra-reader agreements.
通过磁共振成像（MRI）评估用于评估退行性腰椎管狭窄症（LSS）的常用定量和定性图像参数在不同阅片者之间以及同一阅片者内部的一致性。
在这项经伦理委员会批准的横断面多中心研究中，由两名独立阅片者对前瞻性腰椎管狭窄症预后研究（LSOS）中随机选取的100例患者（年龄中位数72.5岁，48%为女性）的MRI进行评估。评估了一组五个先前发表的核心成像参数以及九个关于LSS和腰椎退变的定性和五个定量附加参数，以计算不同阅片者之间一致性的κ值和组内相关系数（ICC）。由一名阅片者进行额外的重复图像评估以计算同一阅片者内部的一致性。
核心图像参数的κ值在不同阅片者之间一致性方面介于0.42（椎间孔区受压）和0.77（脑脊液与马尾神经的关系）之间，在同一阅片者内部一致性方面介于0.59（椎间孔区受压）和0.8（中央区受压）之间。非核心参数的不同阅片者之间一致性显示κ值为0.27 - 0.69，ICC值为0.46 - 0.85。同一阅片者内部一致性显示κ值为0.53 - 0.69，ICC值为0.81 - 0.88。
用于评估LSS的常用定量和定性图像参数在不同阅片者之间以及同一阅片者内部的一致性存在较大差异，先前定义的核心参数在不同阅片者之间以及同一阅片者内部具有良好到优秀的一致性。
