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Establishing the inter-rater reliability of spinal cord damage manual measurement using magnetic resonance imaging

David P Cummins1, Jordan R Connor1, Katherine A Heller1

  • 11Regis University School of Physical Therapy, Denver, CO USA.

Spinal Cord Series and Cases
|June 27, 2019
PubMed
Abstract

Insights

Manual MRI measurements for spinal cord damage after injury are reliable between different raters. This finding supports the use of these quantitative magnetic resonance imaging (MRI) methods in clinical practice and research.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Cervical incomplete spinal cord injury (SCI) requires accurate quantitative assessment of damage.
  • Magnetic resonance imaging (MRI) is crucial for visualizing spinal cord pathology.
  • Establishing reliability in MRI-based measurements is essential for consistent clinical evaluation and research.

Purpose of the Study:

  • To determine the inter-rater reliability of manual MRI-based quantitative measurements of spinal cord damage.
  • To evaluate the consistency of measurements for edema, tissue bridge ratio, damage ratio, and edema volume in cervical incomplete SCI.

Main Methods:

  • Retrospective analysis of structural MRIs from 10 participants with cervical incomplete SCI.
  • Manual measurements of spinal cord damage parameters performed using OsiriX software.
  • Inter-rater reliability assessed using intraclass correlation coefficients (ICC) across seven raters.

Main Results:

  • High-to-excellent inter-rater reliability was achieved for all quantitative MRI measures.
  • Specific ICC values: cranial/caudal levels (0.99), edema length (0.98), midsagittal tissue bridge ratio (0.90), axial damage ratio (0.84), and edema volume (0.93).

Conclusions:

  • Manual MRI measurements for quantifying spinal cord damage demonstrate high reliability among raters.
  • These validated MRI techniques can be confidently employed by researchers and clinicians.
  • Further research is recommended to correlate these measures with functional recovery and guide clinical management of SCI.

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