Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

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

  • Yi, Ji Sook (Department of Radiology, Soonchunhyang University Bucheon Hospital) ;
  • Cha, Jang Gyu (Department of Radiology, Soonchunhyang University Bucheon Hospital) ;
  • Han, Jong Kyu (Department of Radiology, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Hyun-Joo (Department of Radiology, Soonchunhyang University Seoul Hospital)
  • Received : 2014.05.31
  • Accepted : 2015.04.16
  • Published : 2015.08.01
⟨ Previous Next ⟩

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.

Keywords

References

  1. Lunsford LD, Bissonette DJ, Jannetta PJ, Sheptak PE, Zorub DS. Anterior surgery for cervical disc disease. Part 1: Treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 1980;53:1-11 https://doi.org/10.3171/jns.1980.53.1.0001
  2. Radhakrishnan K, Litchy WJ, O'Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain 1994;117(Pt 2):325-335 https://doi.org/10.1093/brain/117.2.325
  3. Daniels DL, Grogan JP, Johansen JG, Meyer GA, Williams AL, Haughton VM. Cervical radiculopathy: computed tomography and myelography compared. Radiology 1984;151:109-113 https://doi.org/10.1148/radiology.151.1.6701298
  4. Shim JH, Park CK, Lee JH, Choi JW, Lee DC, Kim DH, et al. A comparison of angled sagittal MRI and conventional MRI in the diagnosis of herniated disc and stenosis in the cervical foramen. Eur Spine J 2009;18:1109-1116 https://doi.org/10.1007/s00586-009-0932-x
  5. Miyazaki M, Hong SW, Yoon SH, Morishita Y, Wang JC. Reliability of a magnetic resonance imaging-based grading system for cervical intervertebral disc degeneration. J Spinal Disord Tech 2008;21:288-292 https://doi.org/10.1097/BSD.0b013e31813c0e59
  6. Yousem DM, Atlas SW, Hackney DB. Cervical spine disk herniation: comparison of CT and 3DFT gradient echo MR scans. J Comput Assist Tomogr 1992;16:345-351 https://doi.org/10.1097/00004728-199205000-00002
  7. Douglas-Akinwande AC, Rydberg J, Shah MV, Phillips MD, Caldemeyer KS, Lurito JT, et al. Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy: a prospective study. AJR Am J Roentgenol 2010;194:55-61 https://doi.org/10.2214/AJR.09.2988
  8. Larsson EM, Holtas S, Cronqvist S, Brandt L. Comparison of myelography, CT myelography and magnetic resonance imaging in cervical spondylosis and disk herniation. Pre- and postoperative findings. Acta Radiol 1989;30:233-239 https://doi.org/10.1177/028418518903000302
  9. Hudgins WR. Computer-aided diagnosis of lumbar disc herniation. Spine (Phila Pa 1976) 1983;8:604-615 https://doi.org/10.1097/00007632-198309000-00006
  10. Modic MT, Masaryk T, Boumphrey F, Goormastic M, Bell G. Lumbar herniated disk disease and canal stenosis: prospective evaluation by surface coil MR, CT, and myelography. AJR Am J Roentgenol 1986;147:757-765 https://doi.org/10.2214/ajr.147.4.757
  11. Thornbury JR, Fryback DG, Turski PA, Javid MJ, McDonald JV, Beinlich BR, et al. Disk-caused nerve compression in patients with acute low-back pain: diagnosis with MR, CT myelography, and plain CT. Radiology 1993;186:731-738 https://doi.org/10.1148/radiology.186.3.8267688
  12. Dorwart RH, LaMasters DL. Applications of computed tomographic scanning of the cervical spine. Orthop Clin North Am 1985;16:381-393
  13. Wilson DW, Pezzuti RT, Place JN. Magnetic resonance imaging in the preoperative evaluation of cervical radiculopathy. Neurosurgery 1991;28:175-179 https://doi.org/10.1227/00006123-199102000-00001
  14. Fardon DF, Milette PC; Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine (Phila Pa 1976) 2001;26:E93-E113 https://doi.org/10.1097/00007632-200103010-00006
  15. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-174 https://doi.org/10.2307/2529310
  16. van Rijn JC, Klemetso N, Reitsma JB, Bossuyt PM, Hulsmans FJ, Peul WC, et al. Observer variation in the evaluation of lumbar herniated discs and root compression: spiral CT compared with MRI. Br J Radiol 2006;79:372-377 https://doi.org/10.1259/bjr/26216335
  17. Kane AG, Reilly KC, Murphy TF. Swimmer's CT: improved imaging of the lower neck and thoracic inlet. AJNR Am J Neuroradiol 2004;25:859-862

Cited by

  1. Interobserver and Test-Retest Reproducibility of T1ρ and T2 Measurements of Lumbar Intervertebral Discs by 3T Magnetic Resonance Imaging vol.17, pp.6, 2016, https://doi.org/10.3348/kjr.2016.17.6.903
  2. Differentiation of Osteophytes and Disc Herniations in Spinal Radiculopathy Using Susceptibility-Weighted Magnetic Resonance Imaging vol.52, pp.2, 2015, https://doi.org/10.1097/rli.0000000000000314
  3. Selection and Reporting of Statistical Methods to Assess Reliability of a Diagnostic Test: Conformity to Recommended Methods in a Peer-Reviewed Journal vol.18, pp.6, 2017, https://doi.org/10.3348/kjr.2017.18.6.888
  4. Cervical Spine CT Using Spectral Shaping: Can It Be a Solution to Overcome Artifacts in the Lower Cervical Spinal Region? vol.20, pp.3, 2015, https://doi.org/10.3348/kjr.2018.0517
  5. Early presentation of traumatic cervical disc herniation with neurologic deficit and without an adjacent bone lesion vol.43, pp.4, 2015, https://doi.org/10.1007/s00264-018-4117-2
  6. Systematic review of radiological cervical foraminal grading systems vol.63, pp.3, 2015, https://doi.org/10.1007/s00234-020-02596-5