Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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MRI Inter-Reader and Intra-Reader Reliabilities for Assessing Injury Morphology and Posterior Ligamentous Complex Integrity of the Spine According to the Thoracolumbar Injury Classification System and Severity Score

  • Lee, Guen Young (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Lee, Joon Woo (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Choi, Seung Woo (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Lim, Hyun Jin (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Sun, Hye Young (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Kang, Yusuhn (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Chai, Jee Won (Department of Radiology, SMG-SNU Boramae Medical Center) ;
  • Kim, Sujin (Department of Radiology, SMG-SNU Boramae Medical Center) ;
  • Kang, Heung Sik (Department of Radiology, Seoul National University Bundang Hospital)
  • Received : 2014.02.23
  • Accepted : 2015.04.28
  • Published : 2015.08.01
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Abstract

Objective: To evaluate spine magnetic resonance imaging (MRI) inter-reader and intra-reader reliabilities using the thoracolumbar injury classification system and severity score (TLICS) and to analyze the effects of reader experience on reliability and the possible reasons for discordant interpretations. Materials and Methods: Six radiologists (two senior, two junior radiologists, and two residents) independently scored 100 MRI examinations of thoracolumbar spine injuries to assess injury morphology and posterior ligamentous complex (PLC) integrity according to the TLICS. Inter-reader and intra-reader agreements were determined and analyzed according to the number of years of radiologist experience. Results: Inter-reader agreement between the six readers was moderate (k = 0.538 for the first and 0.537 for the second review) for injury morphology and fair to moderate (k = 0.440 for the first and 0.389 for the second review) for PLC integrity. No significant difference in inter-reader agreement was observed according to the number of years of radiologist experience. Intra-reader agreements showed a wide range (k = 0.538-0.822 for injury morphology and 0.423-0.616 for PLC integrity). Agreement was achieved in 44 for the first and 45 for the second review about injury morphology, as well as in 41 for the first and 38 for the second review of PLC integrity. A positive correlation was detected between injury morphology score and PLC integrity. Conclusion: The reliability of MRI for assessing thoracolumbar spinal injuries according to the TLICS was moderate for injury morphology and fair to moderate for PLC integrity, which may not be influenced by radiologist' experience.

Keywords

References

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