Degenerative findings on MRI of the cervical spine: an inter- and intra-rater reliability study
Line Thorndal Moll1,2,3, Morten Wasmod Kindt4, Christina Malmose Stapelfeldt1,2
11DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, DK-8000 Aarhus C, Denmark.
Background:
Knowledge about the assessment reliability of common cervical spine changes is a prerequisite for precise and consistent communication about Magnetic Resonance Imaging (MRI) findings. The purpose of this study was to determine the inter- and intra-rater reliability of degenerative findings when assessing cervical spine MRI.
Methods:
Fifty cervical spine MRIs from subjects with neck pain were used. A radiologist, a chiropractor and a second-year resident of rheumatology independently assessed kyphosis, disc height, disc contour, vertebral endplate signal changes, spinal canal stenosis, neural foraminal stenosis, and osteoarthritis of the uncovertebral and zygapophyseal joints. An evaluation manual was composed containing classifications and illustrative examples, and ten of the MRIs were evaluated twice followed by consensus meetings to refine the classifications. Next, the three readers independently assessed the full sample. Reliability measures were reported using prevalence estimates and unweighted kappa (Κ) statistics.
Results:
The overall inter-rater reliability was substantial (Κ ≥ 0.61) for the majority of variables and moderate only for zygapophyseal osteoarthritis (Κ = 0.56). Intra-rater reliability estimates were higher for all findings.
Conclusions:
The present classifications for some of the most common cervical degenerative findings yielded mainly substantial inter-rater reliability estimates and substantial to almost perfect intra-rater reliability estimates. .
Trial Registration:
Regional Data Protection Agency (J.no. 1-16-02-86-16). The letter of exemption from the Regional Ethical Committee is available from the author on request (case no. 86 / 2017).
Insights
Reliability of cervical spine MRI assessments for common degenerative changes is substantial between raters and even higher within a single rater. This ensures consistent communication of Magnetic Resonance Imaging findings.
Area of Science:
- Radiology
- Orthopedics
- Spine Imaging
Background:
- Accurate assessment of cervical spine Magnetic Resonance Imaging (MRI) findings is crucial for reliable clinical communication.
- Understanding the reliability of interpreting common degenerative changes is a prerequisite for consistent diagnostic reporting.
Purpose of the Study:
- To evaluate the inter-rater and intra-rater reliability of common degenerative findings on cervical spine MRI.
- To establish the consistency of assessments for various cervical spine pathologies among different specialists.
Main Methods:
- Fifty cervical spine MRIs from patients with neck pain were analyzed by a radiologist, chiropractor, and rheumatology resident.
- Assessments included kyphosis, disc height/contour, endplate changes, stenosis, and osteoarthritis, guided by a standardized manual.
- Inter-rater and intra-rater reliability were quantified using prevalence estimates and unweighted kappa statistics.
Main Results:
- Substantial inter-rater reliability (kappa ≥ 0.61) was observed for most assessed cervical spine degenerative findings.
- Moderate inter-rater reliability was noted for zygapophyseal joint osteoarthritis (kappa = 0.56).
- Intra-rater reliability estimates were consistently higher across all evaluated variables.
Conclusions:
- Current classifications for common cervical degenerative findings demonstrate good to excellent reliability.
- The study confirms substantial inter-rater and high intra-rater reliability for cervical spine MRI assessments.
- These findings support consistent and precise communication of degenerative cervical spine MRI results.
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