From the Departments of Radiology (J.F., D.M.M., S.H.F., F.B.M., A.E.F.).
Physical Therapy/Occupational Therapy (L.K.).
AJNR Am J Neuroradiol. 2021 Apr;42(4):787-793. doi: 10.3174/ajnr.A7000. Epub 2021 Feb 11.
The National Institute of Neurological Disorders and Stroke common data elements initiative was created to provide a consistent method for recording and reporting observations related to neurologic diseases in clinical trials. The purpose of this study is to validate the subset of common data elements related to MR imaging evaluation of acute spinal cord injury.
Thirty-five cervical and thoracic MR imaging studies of patients with acute spinal cord injury were evaluated independently in 2 rounds by 5 expert reviewers. Intra- and interrater agreement were calculated for 17 distinct MR imaging observations related to spinal cord injury. These included ordinal, categoric, and continuous measures related to the length and location of spinal cord hemorrhage and edema as well as spinal canal and cord measurements. Level of agreement was calculated using the interclass correlation coefficient and kappa.
The ordinal common data elements spinal cord injury elements for lesion center and rostral or caudal extent of edema or hemorrhage demonstrated agreement ranging from interclass correlation coefficient 0.68 to 0.99. Reproducibility ranged from 0.95 to 1.00. Moderate agreement was observed for absolute length of hemorrhage and edema (0.54 to 0.60) with good reproducibility (0.78 to 0.83). Agreement for the Brain and Spinal Injury Center score showed the lowest interrater agreement with an overall kappa of 0.27 (0.20, 0.34). For 7 of the 8 variables related to spinal cord injury, agreement improved between the first and second evaluation. Continuous diameter measures of the spinal cord and spinal canal using interclass correlation coefficient varied substantially (0.23 to 0.83).
Agreement was more consistent for the ordinal measures of spinal cord injury than continuous measures. Good to excellent agreement on length and location of spinal cord hemorrhage and edema can be achieved with ordinal measures alone.
国家神经疾病与中风研究所的通用数据元素倡议旨在提供一种一致的方法，用于记录和报告临床试验中与神经疾病相关的观察结果。本研究的目的是验证与急性脊髓损伤的磁共振成像评估相关的通用数据元素子集的有效性。
35 例急性脊髓损伤的颈椎和胸椎磁共振成像研究，由 5 名专家独立评估两轮。共评估了 17 项与脊髓损伤相关的磁共振成像观察指标，包括与脊髓出血和水肿的长度和位置以及椎管和脊髓测量相关的有序、分类和连续测量指标。使用组内相关系数和 Kappa 计算一致性水平。
病变中心和水肿或出血的颅尾延伸的脊髓损伤元素的ordinal 通用数据元素具有 0.68 到 0.99 的组内相关系数。再现性范围为 0.95 到 1.00。出血和水肿的绝对长度观察到中度一致性（0.54 到 0.60），再现性良好（0.78 到 0.83）。脑和脊髓损伤中心评分的一致性最低，总体 Kappa 为 0.27（0.20，0.34）。与脊髓损伤相关的 8 个变量中的 7 个变量，在第一次和第二次评估之间的一致性有所提高。使用组内相关系数，脊髓和椎管的连续直径测量值差异很大（0.23 到 0.83）。
脊髓损伤的有序测量比连续测量具有更一致的一致性。仅使用有序测量即可实现脊髓出血和水肿的长度和位置的良好到极好的一致性。
