Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea.
Int J Environ Res Public Health. 2021 Dec 10;18(24):13033. doi: 10.3390/ijerph182413033.
(1) Background: Although radiography performed on the subject in an upright position is considered the standard method for assessing sagittal cervical alignment, it is frequently determined, or reported, based on MRI performed on the subject in a supine position. (2) Methods: Cervical alignment observed in both imaging modalities was assessed using four methods: the C2-7 Cobb angle, the absolute rotation angle (ARA), Borden's method, and the sagittal vertical axis (SVA). Cervical alignment was determined (lordosis, kyphosis, and straight) based on radiography. Then, the diagnostic cut-off values for the MRI images and their corresponding diagnostic accuracies were assessed. (3) Results: The analysis included 142 outpatients. The determined diagnostic cut-off values for lordosis, using three measurements (Cobb angle, ARA, and Borden's method), were -8.5°, -12.5°, and 3.5 mm, respectively, and the cut-off values for kyphosis were -4.5°, 0.5°, and -1.5 mm, respectively. The cut-off value for SVA > 40 mm was 19.5 mm. The Cobb angle, ARA, and Borden's method, on MRI, showed high negative predictive values for determining kyphosis. The SVA on MRI measurements also showed high negative predictive values for determining >40 mm. (4) Conclusions: MRI measurements may be predictive of cervical alignment, especially for the exclusion of kyphosis and SVA > 40 mm. However, caution is needed in the other determinations using MRI, as their accuracies are limited.
(1) 背景：尽管对直立位患者进行放射检查被认为是评估矢状位颈椎曲度的标准方法，但通常根据仰卧位患者进行的 MRI 来确定或报告颈椎曲度。(2) 方法：使用四种方法评估两种影像学模式下的颈椎排列：C2-7 Cobb 角、绝对旋转角（ARA）、Borden 法和矢状垂直轴（SVA）。根据放射学确定颈椎排列（前凸、后凸和直）。然后，评估 MRI 图像的诊断截止值及其相应的诊断准确性。(3) 结果：分析包括 142 名门诊患者。使用三种测量方法（Cobb 角、ARA 和 Borden 法）确定前凸的诊断截止值分别为-8.5°、-12.5°和 3.5mm，后凸的诊断截止值分别为-4.5°、0.5°和-1.5mm。SVA > 40mm 的截止值为 19.5mm。MRI 上的 Cobb 角、ARA 和 Borden 法对确定后凸具有较高的阴性预测值。MRI 测量的 SVA 也对确定>40mm 具有较高的阴性预测值。(4) 结论：MRI 测量值可能对颈椎排列具有预测性，特别是对排除后凸和 SVA > 40mm 具有预测性。然而，在使用 MRI 进行其他测定时需要谨慎，因为其准确性有限。
