Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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A New MRI Grading System for Cervical Foraminal Stenosis Based on Axial T2-Weighted Images

  • Kim, Sujin (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Lee, Joon Woo (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Chai, Jee Won (Department of Radiology, SMG-SNU Boramae Medical Center) ;
  • Yoo, Hye Jin (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kang, Yusuhn (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Seo, Jiwoon (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Ahn, Joong Mo (Department of Radiology, University of Pittsburgh Medical Center) ;
  • Kang, Heung Sik (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center)
  • Received : 2015.01.02
  • Accepted : 2015.07.17
  • Published : 2015.11.01
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Abstract

Objective: The purpose of this study was to evaluate the reliability of a new magnetic resonance imaging (MRI) grading system for cervical neural foraminal stenosis (NFS). Materials and Methods: Cervical NFS at bilateral C4/5, C5/6, and C6/7 was classified into the following three grades based on the T2-weighted axial images: Grade 0 = absence of NFS, with the narrowest width of the neural foramen greater than the width of the extraforaminal nerve root (EFNR); Grade 1 = the narrowest width of the neural foramen the same or less than (but more than 50% of) the width of the EFNR; Grade 2 = the width of the neural foramen the same or less than 50% of the width of the EFNR. The MRIs of 96 patients who were over 60 years old (M:F = 50:46; mean age 68.4 years; range 61-86 years) were independently analyzed by seven radiologists. Interobserver and intraobserver agreements were analyzed using the percentage agreement, kappa statistics, and intraclass correlation coefficient (ICC). Results: For the distinction among the three individual grades at all six neural foramina, the ICC ranged from 0.68 to 0.73, indicating fair to good reproducibility. The percentage agreement ranged from 60.2% to 70.6%, and the kappa values (${\kappa}$ = 0.50-0.58) indicated fair to moderate agreement. The percentages of intraobserver agreement ranged from 85.4% to 93.8% (${\kappa}$ = 0.80-0.92), indicating near perfect agreement. Conclusion: The new MRI grading system shows sufficient interobserver and intraobserver agreement to reliably assess cervical NFS.

Keywords

References

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