Observer variation in the evaluation of lumbar herniated discs and root compression: spiral CT compared with MRI

The British Journal of Radiology
Jeroen C van RijnCharles B L M Majoie

Abstract

Spiral CT is considered the best alternative for MRI in the evaluation of herniated discs. The purpose of this study was to compare radiological evaluation of spiral CT with MRI in patients suspected of herniated discs. 57 patients with lumbosacral radicular syndrome underwent spiral CT and 1.5 T MRI. Two neuroradiologists independently evaluated 171 intervertebral discs for herniation or "bulge" and 456 nerve roots for root compression, once after CT and once after MRI. We compared interobserver agreement using the kappa statistic and we performed a paired comparison between CT and MRI. For detection of herniated or bulging discs, we observed no significant difference in interobserver agreement (CT kappa 0.66 vs MRI kappa 0.71; p = 0.40). For root compression, we observed significantly better interobserver agreement at MRI evaluation (CT kappa 0.59 vs MRI kappa 0.78; p = 0.01). In 30 of 171 lumbar discs (18%) and in 54 of 456 nerve roots (12%), the observers disagreed on whether CT results were similar to MRI. In the cases without disagreement, CT differed from MRI in 6 discs (3.5%) and in 3 nerve roots (0.7%). For radiological evaluation of lumbar herniated discs, we found no evidence that spiral CT is inferior to MRI. For ev...Continue Reading

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Citations

Mar 20, 2014·The Spine Journal : Official Journal of the North American Spine Society·Michael C FuJonathan N Grauer
Jun 22, 2014·Surgical and Radiologic Anatomy : SRA·Frédéric KhiamiCaroline Hirsch
Feb 16, 2013·European Journal of Radiology·Soo Jin LeeSang Eun Kim
Jan 23, 2016·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Koen Van BoxemAlfons Kessels
May 31, 2012·Radiologic Clinics of North America·Filippo Del GrandeJohn A Carrino
Oct 28, 2010·Physical Medicine and Rehabilitation Clinics of North America·Timothy Maus
Feb 23, 2010·The Spine Journal : Official Journal of the North American Spine Society·Stephan W TohtzMichael Putzier
Nov 13, 2007·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mustafa GüvençerSüleyman Tetik
Aug 25, 2009·Veterinary Radiology & Ultrasound : the Official Journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association·Silke HechtWilliam H Adams
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