Readability of extraspinal organs on scout images of lumbar spine MRI according to different protocols

Scout images of lumbar spine MRI often include the extraspinal organs, which are barely included in routine MRI and can be a potential cause of lumbar pain.

To evaluate the readability of scout images for extraspinal organs in lumbar spine MRI according to different protocols.

A total of 150 patients who underwent 1.5 T or 3 T lumbar spine MRI from March to September 2015 at three hospitals with different scout image protocols, were selected. Two radiologists independently reviewed the scout images to investigate whether exclusive diagnosis of major diseases involving the femoral head, femoral neck, sacroiliac joint, and kidneys was possible. Readability levels were divided into four categories: definitely, possibly, limited, and non-evaluable. The readability of scout images according to the protocols was compared using Chi-square test. Interobserver agreement for the readability level of scout images was assessed using weighted κ statistics.

Of 150 patients, "definitely evaluable" cases classified by two readers were 50-62 (33.3-41.3%) for femoral head (κ = 0.63-0.71), 37-66 (24.7-44.0%) for femoral neck (κ = 0.41-0.48), 72-93 (48.0-62.0%) for sacroiliac joint (κ = 0.35-0.37), and 63-73 (42.0-48.7%) for kidneys (κ = 0.45-0.47). More than 50% of femoral heads were classified as readable (definitely or possible evaluable) cases by two readers with excellent interobserver agreement. The readability level of scout images was significantly different according to image protocols including the MRI sequence, number of coronal plane slices, and intersection gap of coronal plane slices (p≤0.015).

Scout images of lumbar spine MRI may be readable enough to rule out some major diseases of extraspinal organs. Standardization of the protocol will be needed to validate the potential role of scout images for screening extraspinal organs.