Hajiahmadi Somayeh, Shayganfar Azin, Askari Mahsa, Ebrahimian Shadi
Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Heliyon. 2020 Nov 4;6(11):e05201. doi: 10.1016/j.heliyon.2020.e05201. eCollection 2020 Nov.
Magnetic resonance imaging (MRI) is usually the modality of choice to assess sciatica and intervertebral disc herniation. Despite remarkable progression in diagnostic imaging and surgical techniques, definite diagnosis based on imaging interpretation is still a great challenge. The aim of this study was to determine interobserver and intraobserver variability in reporting lumbar MRI between two neuroradiologists based on the new 2014 version of disc nomenclature.
The study population was composed of 134 irresponsive to conservative therapy patients with clinical presentations of disc herniation and lumbar radiculopathy. MRI was taken from all the participants using a 1.5 T MRI system. Two neuroradiologists evaluated the images, separately and one of them did it twice and interpreted the scans in sagittal and axial planes. Disc bulge, disc herniation and nerve root compression were evaluated at each level. Interobserver and interaobserver agreements between two neuroradiologists, and one neuroradiologist in two times of reporting were calculated for the evaluation of bulging and herniated discs and nerve root compression by applying the Kappa statistics.
Bulging disc, herniated disc, the type of disc, location of the discs, and nerve root compression diagnosis were significantly in excellent agreement (kappa>0.7, p-value<0.001) through intraobserver assessments, while interobserver assessments presented statistically significant with a fair agreement (kappa:0.4-0.7 and p-value<0.05).
Remarkable intraobserver agreement was found between diagnoses of disc-related pathologies of the lumbar spine while interobserver assessments revealed only fair concordance.
磁共振成像（MRI）通常是评估坐骨神经痛和椎间盘突出症的首选检查方式。尽管诊断成像和手术技术取得了显著进展，但基于影像解读进行明确诊断仍是一项巨大挑战。本研究的目的是根据2014年新版椎间盘命名法，确定两名神经放射科医生在报告腰椎MRI时的观察者间和观察者内变异性。
研究人群由134例对保守治疗无反应、有椎间盘突出和腰椎神经根病临床表现的患者组成。使用1.5T MRI系统对所有参与者进行MRI检查。两名神经放射科医生分别对图像进行评估，其中一人进行两次评估，并在矢状面和轴位面上解读扫描结果。对每个节段的椎间盘膨出、椎间盘突出和神经根受压情况进行评估。通过应用Kappa统计量，计算两名神经放射科医生之间以及一名神经放射科医生两次报告之间的观察者间和观察者内一致性，以评估椎间盘膨出和突出以及神经根受压情况。
通过观察者内评估，椎间盘膨出、椎间盘突出、椎间盘类型、椎间盘位置和神经根受压诊断的一致性非常好（kappa>0.7，p值<0.001），而观察者间评估显示具有统计学意义的中等一致性（kappa：0.4 - 0.7且p值<0.05）。
在腰椎椎间盘相关病变的诊断中，观察者内一致性显著，而观察者间评估仅显示中等程度的一致性。
