Barim Menekse Salar, Capanoglu M Fehmi, Sesek Richard F, Gallagher Sean, Schall Mark C, Beyers Ronald J, Davis Gerard A
Division of Field Studies and Engineering (DFSE), Engineering and Physical Hazards Branch (EPHB), Human Factors and Ergonomics Team (HFET), National Institute of Occupational Safety and Health (NIOSH), 1090 Tusculum Avenue, Cincinnati, OH, 45226, USA.
Department of Industrial and Systems Engineering, Auburn University, 3301 Shelby Center, Auburn, AL, 36849-5346, USA.
Eur Spine J. 2025 Mar;34(3):887-895. doi: 10.1007/s00586-025-08649-8. Epub 2025 Jan 19.
Magnetic resonance imaging (MRI) is increasingly used to estimate the geometric dimensions of lower lumbar vertebrae. While MRI-based measurements have demonstrated good reliability with interclass correlation coefficients (ICCs) of 0.80 or higher, many evaluations focus solely on the comparison of identical MRI images. This approach primarily reflects analyst dexterity and does not assess the reliability of the entire process, including imaging and image selection.
To evaluate the inter- and intra-rater reliability of the entire process of using MRI to measure biomechanically relevant lumbar spinal characteristics, incorporating imaging, image selection, and analysis.
A dataset of 144 low-back MRI scans was analyzed. Reliability assessments were performed under different conditions: (1) identical scans rated by the same analyst at different times (intra-rater reliability) and (2) distinct scans of the same subject obtained by different MRI operators and analyzed by different analysts (inter-rater reliability). Mean absolute differences in measurements were calculated, and sources of variability, such as breathing artifacts, were noted.
Larger discrepancies were observed when comparing distinct scans analyzed by different MRI operators and analysts. In the "worst-case" scenario, where both the MRI operator and analyst differed, a 4.05% mean absolute difference was noted for anterior endplate measurements. This was higher than the 2.76% difference observed when analysts re-rated their own scans after one month. Despite these discrepancies, the variability in measurements was relatively low and primarily attributed to factors like breathing artifacts.
The process of using MRI to derive biomechanical measures, particularly for bony structures, demonstrates robust reliability. Variability in measurements is minimal even under challenging conditions, supporting the use of MRI for biomechanical assessments.
磁共振成像（MRI）越来越多地用于估计下腰椎的几何尺寸。虽然基于MRI的测量已显示出良好的可靠性，组内相关系数（ICC）为0.80或更高，但许多评估仅专注于相同MRI图像的比较。这种方法主要反映了分析人员的熟练程度，并未评估整个过程的可靠性，包括成像和图像选择。
评估使用MRI测量生物力学相关腰椎特征的整个过程的评分者间和评分者内可靠性，包括成像、图像选择和分析。
分析了144例低背MRI扫描的数据集。在不同条件下进行可靠性评估：（1）同一分析人员在不同时间对相同扫描进行评分（评分者内可靠性），以及（2）不同MRI操作人员获得并由不同分析人员分析的同一受试者的不同扫描（评分者间可靠性）。计算测量的平均绝对差异，并记录变异性来源，如呼吸伪影。
在比较由不同MRI操作人员和分析人员分析的不同扫描时，观察到较大差异。在“最坏情况”下，即MRI操作人员和分析人员都不同时，前端板测量的平均绝对差异为4.05%。这高于分析人员在一个月后重新对自己的扫描进行评分时观察到的2.76%的差异。尽管存在这些差异，但测量的变异性相对较低，主要归因于呼吸伪影等因素。
使用MRI得出生物力学测量值的过程，特别是对于骨结构，显示出强大的可靠性。即使在具有挑战性的条件下，测量的变异性也很小，支持将MRI用于生物力学评估。
