MRI evaluation of lumbar spinal stenosis: is a rapid visual assessment as good as area measurement?

作者：Lonne Greger^*; Odegard Bent; Johnsen Lars Gunnar; Solberg Tore K; Kvistad Kjell Arne; Nygaard Oystein P

来源：European Spine Journal, 2014, 23(6): 1320-1324.

DOI：10.1007/s00586-014-3248-4

• Lumbar spinal stenosis
• Magnetic resonance imaging
• Classification
• Reproducibility
• Neurogenic claudication

Lumbar spinal stenosis (LSS) is commonly assessed on MRI by measuring dural sac cross-sectional area (DSCA). A new method, morphological grading A-D, has recently been introduced as an alternative method. %26lt;br%26gt;The aim of this study is to compare these two different methods for assessing LSS on MRI and study their reliability and intercorrelation. %26lt;br%26gt;On pretreatment MRI of 84 patients, two experienced radiologists independently classified level L2/L3, L3/L4 and L4/L5 as no, relative or significant stenosis using both methods. Agreement was analyzed by weighted Kappa. The correlation between the two methods was analysed using Spearman correlation, and visualized in a box plot. %26lt;br%26gt;The interobserver agreement (95 % CI) was 0.69 (0.61-0.77) and 0.65 (0.56-0.74), respectively. The intraobserver agreements for DSCA were 0.77 (0.60-0.74) and 0.80 (0.66-0.93). On morphological grading A-D it was 0.78 (0.65-0.92) and 0.81 (0.68-0.94). The correlation coefficient between the two methods was 0.85 (p %26lt; 0.001). Grades C and D were under the limit value for significant stenosis using the DSCA. %26lt;br%26gt;The study shows that the inter- and intraobserver agreements of DSCA and morphological grading A-D were acceptable and their intercorrelation is strong. Both methods may be used in the MRI evaluation of LSS.

• 出版日期2014-6