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Published on: March 23, 2019
MRI evaluation of lumbar spinal stenosis: is a rapid visual assessment as good as area measurement?
Greger Lønne1, Bent Ødegård, Lars Gunnar Johnsen
1Department of Orthopaedic Surgery, Innlandet Hospital Trust, Anders Sandvigsgt 17, 2609, Lillehammer, Norway, greger.lonne@ntnu.no.
Background:
Lumbar spinal stenosis (LSS) is commonly assessed on MRI by measuring dural sac cross-sectional area (DSCA). A new method, morphological grading A-D, has recently been introduced as an alternative method.
Objective:
The aim of this study is to compare these two different methods for assessing LSS on MRI and study their reliability and intercorrelation.
Methods:
On pretreatment MRI of 84 patients, two experienced radiologists independently classified level L2/L3, L3/L4 and L4/L5 as no, relative or significant stenosis using both methods. Agreement was analyzed by weighted Kappa. The correlation between the two methods was analysed using Spearman correlation, and visualized in a box plot.
Results:
The interobserver agreement (95 % CI) was 0.69 (0.61-0.77) and 0.65 (0.56-0.74), respectively. The intraobserver agreements for DSCA were 0.77 (0.60-0.74) and 0.80 (0.66-0.93). On morphological grading A-D it was 0.78 (0.65-0.92) and 0.81 (0.68-0.94). The correlation coefficient between the two methods was 0.85 (p < 0.001). Grades C and D were under the limit value for significant stenosis using the DSCA.
Conclusions:
The study shows that the inter- and intraobserver agreements of DSCA and morphological grading A-D were acceptable and their intercorrelation is strong. Both methods may be used in the MRI evaluation of LSS.
