Department of Radiology, S & K Hospital, Daejeon, Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
PLoS One. 2021 May 13;16(5):e0251310. doi: 10.1371/journal.pone.0251310. eCollection 2021.
Scout images of lumbar spine MRI often include the extraspinal organs, which are barely included in routine MRI and can be a potential cause of lumbar pain.
To evaluate the readability of scout images for extraspinal organs in lumbar spine MRI according to different protocols.
A total of 150 patients who underwent 1.5 T or 3 T lumbar spine MRI from March to September 2015 at three hospitals with different scout image protocols, were selected. Two radiologists independently reviewed the scout images to investigate whether exclusive diagnosis of major diseases involving the femoral head, femoral neck, sacroiliac joint, and kidneys was possible. Readability levels were divided into four categories: definitely, possibly, limited, and non-evaluable. The readability of scout images according to the protocols was compared using Chi-square test. Interobserver agreement for the readability level of scout images was assessed using weighted κ statistics.
Of 150 patients, "definitely evaluable" cases classified by two readers were 50-62 (33.3-41.3%) for femoral head (κ = 0.63-0.71), 37-66 (24.7-44.0%) for femoral neck (κ = 0.41-0.48), 72-93 (48.0-62.0%) for sacroiliac joint (κ = 0.35-0.37), and 63-73 (42.0-48.7%) for kidneys (κ = 0.45-0.47). More than 50% of femoral heads were classified as readable (definitely or possible evaluable) cases by two readers with excellent interobserver agreement. The readability level of scout images was significantly different according to image protocols including the MRI sequence, number of coronal plane slices, and intersection gap of coronal plane slices (p≤0.015).
Scout images of lumbar spine MRI may be readable enough to rule out some major diseases of extraspinal organs. Standardization of the protocol will be needed to validate the potential role of scout images for screening extraspinal organs.
腰椎 MRI 的扫描图像常包括脊柱外器官，这些器官在常规 MRI 中几乎不包括在内，但可能是腰痛的潜在原因。
根据不同的方案评估腰椎 MRI 中脊柱外器官扫描图像的可读性。
选取 2015 年 3 月至 9 月在三所医院进行 1.5 T 或 3 T 腰椎 MRI 的 150 例患者。两位放射科医生分别对扫描图像进行了独立的评估，以调查是否可以独家诊断涉及股骨头、股骨颈、骶髂关节和肾脏的主要疾病。可读性水平分为四级：肯定、可能、有限、无法评估。使用卡方检验比较根据方案得出的扫描图像的可读性。使用加权 κ 统计评估观察者之间对扫描图像可读性水平的一致性。
在 150 例患者中，两位观察者对“肯定可评估”病例的分类为股骨头 50-62 例（33.3-41.3%）（κ=0.63-0.71），股骨颈 37-66 例（24.7-44.0%）（κ=0.41-0.48），骶髂关节 72-93 例（48.0-62.0%）（κ=0.35-0.37），肾脏 63-73 例（42.0-48.7%）（κ=0.45-0.47）。两位观察者之间具有极好的一致性，超过 50%的股骨头被归类为可读（肯定或可能可评估）病例。扫描图像的可读性水平根据包括 MRI 序列、冠状面切片数量和冠状面切片交叉间隙在内的方案有显著差异（p≤0.015）。
腰椎 MRI 的扫描图像可能具有足够的可读性，足以排除脊柱外器官的一些主要疾病。需要对方案进行标准化，以验证扫描图像筛查脊柱外器官的潜在作用。
