Limits...
Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI.

Yi JS, Cha JG, Han JK, Kim HJ - Korean J Radiol (2015)

Bottom Line: Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial.MDCT tended to underestimate the extent of herniated disc lesions compared with MRI.MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon 420-767, Korea.

ABSTRACT

Objective: To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI).

Materials and methods: Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI.

Results: The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI.

Conclusion: Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

No MeSH data available.


Related in: MedlinePlus

Comparison of cervical MRI and MDCT in 43-year-old female with posterior neck pain.Central disc protrusion is evident at C3-4 level on MRI (A, B; arrows). However, all readers interpreted disc as normal on MDCT (C, D). MDCT = multidetector-row computed tomography, MRI = magnetic resonance imaging
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4499554&req=5

Figure 4: Comparison of cervical MRI and MDCT in 43-year-old female with posterior neck pain.Central disc protrusion is evident at C3-4 level on MRI (A, B; arrows). However, all readers interpreted disc as normal on MDCT (C, D). MDCT = multidetector-row computed tomography, MRI = magnetic resonance imaging

Mentions: Table 1 shows the interobserver agreement in the evaluation of disc morphology among the three readers, revealing fair to moderate agreement (k = 0.39-0.53 on MDCT images; k = 0.45-0.56 on MRI). When disc morphology was categorized using a two-grade system (normal and bulging vs. protrusion and extrusion), the inter-modality agreement between MDCT and MRI was only moderate (k = 0.59). When disc morphology was categorized using a four-grade system, the inter-modality agreement between MDCT and MRI was substantial (k = 0.66) (Table 2). However, no significant difference in terms of agreement between MDCT and MRI findings was evident when the four- and two-grade systems were compared (p = 0.37). Compared with the MRI findings, 9 of 55 (16.4%) bulging discs, 26 of 79 (32.9%) disc protrusions, and 4 of 6 (66.7%) disc extrusions were underestimated on MDCT images, whereas 11 of 115 (9.6%) normal discs, 12 of 55 (21.8%) bulging discs, and 3 of 79 (3.8%) disc protrusions were overestimated on MDCT images (Table 2). In both the four- and two-grade systems, herniated disc lesions on MDCT images tended to be underestimated compared with MRI imaging findings (Fig. 4). The inter-modality agreement between MDCT and MRI increased slightly, to 82.4% (210/255), when the disc morphology was divided into non-pathologic (normal and bulging) and pathologic (protrusion and extrusion) presentations. Using the two-grade system, 27 of 85 (31.8%) disc herniations on MDCT findings were underestimated, whereas 18 of 160 non-pathologic discs on MDCT were overestimated, compared with MRI.


Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI.

Yi JS, Cha JG, Han JK, Kim HJ - Korean J Radiol (2015)

Comparison of cervical MRI and MDCT in 43-year-old female with posterior neck pain.Central disc protrusion is evident at C3-4 level on MRI (A, B; arrows). However, all readers interpreted disc as normal on MDCT (C, D). MDCT = multidetector-row computed tomography, MRI = magnetic resonance imaging
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499554&req=5

Figure 4: Comparison of cervical MRI and MDCT in 43-year-old female with posterior neck pain.Central disc protrusion is evident at C3-4 level on MRI (A, B; arrows). However, all readers interpreted disc as normal on MDCT (C, D). MDCT = multidetector-row computed tomography, MRI = magnetic resonance imaging
Mentions: Table 1 shows the interobserver agreement in the evaluation of disc morphology among the three readers, revealing fair to moderate agreement (k = 0.39-0.53 on MDCT images; k = 0.45-0.56 on MRI). When disc morphology was categorized using a two-grade system (normal and bulging vs. protrusion and extrusion), the inter-modality agreement between MDCT and MRI was only moderate (k = 0.59). When disc morphology was categorized using a four-grade system, the inter-modality agreement between MDCT and MRI was substantial (k = 0.66) (Table 2). However, no significant difference in terms of agreement between MDCT and MRI findings was evident when the four- and two-grade systems were compared (p = 0.37). Compared with the MRI findings, 9 of 55 (16.4%) bulging discs, 26 of 79 (32.9%) disc protrusions, and 4 of 6 (66.7%) disc extrusions were underestimated on MDCT images, whereas 11 of 115 (9.6%) normal discs, 12 of 55 (21.8%) bulging discs, and 3 of 79 (3.8%) disc protrusions were overestimated on MDCT images (Table 2). In both the four- and two-grade systems, herniated disc lesions on MDCT images tended to be underestimated compared with MRI imaging findings (Fig. 4). The inter-modality agreement between MDCT and MRI increased slightly, to 82.4% (210/255), when the disc morphology was divided into non-pathologic (normal and bulging) and pathologic (protrusion and extrusion) presentations. Using the two-grade system, 27 of 85 (31.8%) disc herniations on MDCT findings were underestimated, whereas 18 of 160 non-pathologic discs on MDCT were overestimated, compared with MRI.

Bottom Line: Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial.MDCT tended to underestimate the extent of herniated disc lesions compared with MRI.MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon 420-767, Korea.

ABSTRACT

Objective: To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI).

Materials and methods: Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI.

Results: The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI.

Conclusion: Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

No MeSH data available.


Related in: MedlinePlus