Lee Jung Eun, Park Hee Jin, Lee So Yeon, Lee Yong Taek, Kim Yong Bum, Lee Kyu Hong, Shin Hyunchul, Kwon Young Joon
From the Departments of *Radiology, †Rehabilitation Medicine, ‡Neurology, and §Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Comput Assist Tomogr. 2017 Nov/Dec;41(6):926-930. doi: 10.1097/RCT.0000000000000628.
OBJECTIVE: Park system is a magnetic resonance imaging (MRI) grading system for cervical neural foraminal stenosis (CNFS) and consists of 4 grades (0-3) based on the foraminal shape of 45-degree T2-weighted oblique sagittal images. The objective of this study was to evaluate the interreader reliability of the Park system among radiologists, residents, and clinicians. This study also assessed the correlations between radiologic and clinical findings. MATERIAL AND METHODS: A total of 289 patients (men:women = 155:134, mean age = 50 years) who underwent oblique sagittal MRI of the cervical spine at our hospital were included. According to the MR grading system suggested by Park et al (Br J Radiol 2013;86:20120515), 2 radiologists, 2 trainees, and 2 clinicians measured CNFS grade at the most narrow point. A neurosurgeon assessed the associated clinical manifestations. κ statistics were used to analyze the interreader agreement among the radiologists and clinicians. The clinical correlations between grade and positive clinical manifestations were assessed with R using nonparametric correlation analysis (Spearman correlation). RESULTS: The overall interreader agreements between radiologists, between trainees, between clinicians, and between radiologists and clinicians were almost perfect (κ = 0.80-0.96). There were moderate correlations between grade and clinical manifestations in each group (R = 0.562-0.669). There were moderate to relatively high correlations between grade and neurologic manifestations based on cervical level (R = 0.570-0.715) (all P < 0.05). CONCLUSIONS: Regardless of reader experience, there was substantial to almost perfect interreader reliability with the Park system for CNFS based on oblique sagittal MRI.
目的:帕克系统是一种用于颈椎神经孔狭窄(CNFS)的磁共振成像(MRI)分级系统,基于45度T2加权斜矢状位图像的椎间孔形状分为4级(0 - 3级)。本研究的目的是评估放射科医生、住院医师和临床医生之间帕克系统的阅片者间可靠性。本研究还评估了影像学和临床发现之间的相关性。 材料与方法:纳入我院289例接受颈椎斜矢状位MRI检查的患者(男性∶女性 = 155∶134,平均年龄 = 50岁)。根据帕克等人提出的MR分级系统(《英国放射学杂志》2013年;86卷:20120515),2名放射科医生、2名实习医生和2名临床医生在最狭窄点测量CNFS分级。一名神经外科医生评估相关临床表现。κ统计用于分析放射科医生和临床医生之间的阅片者间一致性。使用R通过非参数相关分析(斯皮尔曼相关性)评估分级与阳性临床表现之间的临床相关性。 结果:放射科医生之间、实习医生之间、临床医生之间以及放射科医生与临床医生之间的总体阅片者间一致性几乎为完美(κ = 0.80 - 0.96)。每组中分级与临床表现之间存在中度相关性(R = 0.562 - 0.669)。基于颈椎节段,分级与神经学表现之间存在中度至较高相关性(R = 0.570 - 0.715)(所有P < 0.05)。 结论:无论阅片者经验如何,基于斜矢状位MRI的帕克系统对CNFS的阅片者间可靠性很高,几乎达到完美。
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