Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy: A prospective study

Annette C. Douglas-Akinwande, Jonas Rydberg, Mitesh V. Shah, Michael D. Phillips, Karen S. Caldemeyer, Joseph T. Lurito, Jun Ying, Vincent Mathews

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to determine the accuracy of IV contrast-enhanced MDCT and MRI for evaluation of the severity and cause of neural foraminal stenosis in patients with cervical radiculopathy. SUBJECTS AND METHODS. Eighteen patients with cervical radiculopathy prospectively underwent contrast-enhanced MDCT and MRI. Contrast-enhanced MDCT scans were acquired at 1-mm thickness and reconstructed in oblique axial (parallel to disk) and sagittal (perpendicular to neural foramen) 2-mm sections without a gap. The MRI sequences used were sagittal T1-weighted, fast spin-echo T2-weighted, 3D fast spin-echo T2-weighted, axial T2-weighted, and 3D gradient-recalled echo. Three neuroradiologists independently and blindly rated the severity and cause of neural foraminal stenosis on a 4-point scale. Using the same scale at surgery, one of three surgeons rated the severity and cause of neural foraminal stenosis, and the results were used as the reference standard. Interobserver and intraobserver agreement (κ) was calculated. RESULTS. For severity of neural foraminal stenosis, the sensitivities of contrast-enhanced MDCT (50/55, 91%) and MRI (55/57, 96%) were similar, as were their specificities (contrast-enhanced MDCT, 13/24, 54%; MRI, 11/24, 46%). For cause of neural foraminal stenosis, the accuracies of contrast-enhanced MDCT (46/54, 85%) and MRI (45/57, 79%) were similar. Interobserver agreement on severity of neural foraminal stenosis was moderate to almost perfect for contrast-enhanced MDCT (κ = 0.50-1.00) and MRI (κ = 0.43-1.00). For cause of neural foraminal stenosis, interobserver agreement was moderate to substantial for contrast-enhanced MDCT (κ = 0.52-0.76) but only fair for MRI (κ = 0.23-0.39). Intra observer agreement was very high for severity of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.85; MRI, κ = 0.80) and cause of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.86; MRI, κ = 1.00). CONCLUSION. Contrast-enhanced MDCT is as accurate as MRI in evaluation of the severity and cause of neural foraminal stenosis and may have better interobserver agreement.

Original languageEnglish (US)
Pages (from-to)55-61
Number of pages7
JournalAmerican Journal of Roentgenology
Volume194
Issue number1
DOIs
StatePublished - Jan 2010

Fingerprint

Radiculopathy
Pathologic Constriction
Prospective Studies
Contrast Sensitivity

Keywords

  • Cervical radiculopathy
  • Contrast material
  • CT
  • Degenerative disease
  • Disk herniation
  • Neural foraminal stenosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy : A prospective study. / Douglas-Akinwande, Annette C.; Rydberg, Jonas; Shah, Mitesh V.; Phillips, Michael D.; Caldemeyer, Karen S.; Lurito, Joseph T.; Ying, Jun; Mathews, Vincent.

In: American Journal of Roentgenology, Vol. 194, No. 1, 01.2010, p. 55-61.

Research output: Contribution to journalArticle

Douglas-Akinwande, Annette C. ; Rydberg, Jonas ; Shah, Mitesh V. ; Phillips, Michael D. ; Caldemeyer, Karen S. ; Lurito, Joseph T. ; Ying, Jun ; Mathews, Vincent. / Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy : A prospective study. In: American Journal of Roentgenology. 2010 ; Vol. 194, No. 1. pp. 55-61.
@article{c6ee9c5873f64a20bff7a51c656c9b0c,
title = "Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy: A prospective study",
abstract = "OBJECTIVE. The purpose of this study was to determine the accuracy of IV contrast-enhanced MDCT and MRI for evaluation of the severity and cause of neural foraminal stenosis in patients with cervical radiculopathy. SUBJECTS AND METHODS. Eighteen patients with cervical radiculopathy prospectively underwent contrast-enhanced MDCT and MRI. Contrast-enhanced MDCT scans were acquired at 1-mm thickness and reconstructed in oblique axial (parallel to disk) and sagittal (perpendicular to neural foramen) 2-mm sections without a gap. The MRI sequences used were sagittal T1-weighted, fast spin-echo T2-weighted, 3D fast spin-echo T2-weighted, axial T2-weighted, and 3D gradient-recalled echo. Three neuroradiologists independently and blindly rated the severity and cause of neural foraminal stenosis on a 4-point scale. Using the same scale at surgery, one of three surgeons rated the severity and cause of neural foraminal stenosis, and the results were used as the reference standard. Interobserver and intraobserver agreement (κ) was calculated. RESULTS. For severity of neural foraminal stenosis, the sensitivities of contrast-enhanced MDCT (50/55, 91{\%}) and MRI (55/57, 96{\%}) were similar, as were their specificities (contrast-enhanced MDCT, 13/24, 54{\%}; MRI, 11/24, 46{\%}). For cause of neural foraminal stenosis, the accuracies of contrast-enhanced MDCT (46/54, 85{\%}) and MRI (45/57, 79{\%}) were similar. Interobserver agreement on severity of neural foraminal stenosis was moderate to almost perfect for contrast-enhanced MDCT (κ = 0.50-1.00) and MRI (κ = 0.43-1.00). For cause of neural foraminal stenosis, interobserver agreement was moderate to substantial for contrast-enhanced MDCT (κ = 0.52-0.76) but only fair for MRI (κ = 0.23-0.39). Intra observer agreement was very high for severity of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.85; MRI, κ = 0.80) and cause of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.86; MRI, κ = 1.00). CONCLUSION. Contrast-enhanced MDCT is as accurate as MRI in evaluation of the severity and cause of neural foraminal stenosis and may have better interobserver agreement.",
keywords = "Cervical radiculopathy, Contrast material, CT, Degenerative disease, Disk herniation, Neural foraminal stenosis",
author = "Douglas-Akinwande, {Annette C.} and Jonas Rydberg and Shah, {Mitesh V.} and Phillips, {Michael D.} and Caldemeyer, {Karen S.} and Lurito, {Joseph T.} and Jun Ying and Vincent Mathews",
year = "2010",
month = "1",
doi = "10.2214/AJR.09.2988",
language = "English (US)",
volume = "194",
pages = "55--61",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "1",

}

TY - JOUR

T1 - Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy

T2 - A prospective study

AU - Douglas-Akinwande, Annette C.

AU - Rydberg, Jonas

AU - Shah, Mitesh V.

AU - Phillips, Michael D.

AU - Caldemeyer, Karen S.

AU - Lurito, Joseph T.

AU - Ying, Jun

AU - Mathews, Vincent

PY - 2010/1

Y1 - 2010/1

N2 - OBJECTIVE. The purpose of this study was to determine the accuracy of IV contrast-enhanced MDCT and MRI for evaluation of the severity and cause of neural foraminal stenosis in patients with cervical radiculopathy. SUBJECTS AND METHODS. Eighteen patients with cervical radiculopathy prospectively underwent contrast-enhanced MDCT and MRI. Contrast-enhanced MDCT scans were acquired at 1-mm thickness and reconstructed in oblique axial (parallel to disk) and sagittal (perpendicular to neural foramen) 2-mm sections without a gap. The MRI sequences used were sagittal T1-weighted, fast spin-echo T2-weighted, 3D fast spin-echo T2-weighted, axial T2-weighted, and 3D gradient-recalled echo. Three neuroradiologists independently and blindly rated the severity and cause of neural foraminal stenosis on a 4-point scale. Using the same scale at surgery, one of three surgeons rated the severity and cause of neural foraminal stenosis, and the results were used as the reference standard. Interobserver and intraobserver agreement (κ) was calculated. RESULTS. For severity of neural foraminal stenosis, the sensitivities of contrast-enhanced MDCT (50/55, 91%) and MRI (55/57, 96%) were similar, as were their specificities (contrast-enhanced MDCT, 13/24, 54%; MRI, 11/24, 46%). For cause of neural foraminal stenosis, the accuracies of contrast-enhanced MDCT (46/54, 85%) and MRI (45/57, 79%) were similar. Interobserver agreement on severity of neural foraminal stenosis was moderate to almost perfect for contrast-enhanced MDCT (κ = 0.50-1.00) and MRI (κ = 0.43-1.00). For cause of neural foraminal stenosis, interobserver agreement was moderate to substantial for contrast-enhanced MDCT (κ = 0.52-0.76) but only fair for MRI (κ = 0.23-0.39). Intra observer agreement was very high for severity of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.85; MRI, κ = 0.80) and cause of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.86; MRI, κ = 1.00). CONCLUSION. Contrast-enhanced MDCT is as accurate as MRI in evaluation of the severity and cause of neural foraminal stenosis and may have better interobserver agreement.

AB - OBJECTIVE. The purpose of this study was to determine the accuracy of IV contrast-enhanced MDCT and MRI for evaluation of the severity and cause of neural foraminal stenosis in patients with cervical radiculopathy. SUBJECTS AND METHODS. Eighteen patients with cervical radiculopathy prospectively underwent contrast-enhanced MDCT and MRI. Contrast-enhanced MDCT scans were acquired at 1-mm thickness and reconstructed in oblique axial (parallel to disk) and sagittal (perpendicular to neural foramen) 2-mm sections without a gap. The MRI sequences used were sagittal T1-weighted, fast spin-echo T2-weighted, 3D fast spin-echo T2-weighted, axial T2-weighted, and 3D gradient-recalled echo. Three neuroradiologists independently and blindly rated the severity and cause of neural foraminal stenosis on a 4-point scale. Using the same scale at surgery, one of three surgeons rated the severity and cause of neural foraminal stenosis, and the results were used as the reference standard. Interobserver and intraobserver agreement (κ) was calculated. RESULTS. For severity of neural foraminal stenosis, the sensitivities of contrast-enhanced MDCT (50/55, 91%) and MRI (55/57, 96%) were similar, as were their specificities (contrast-enhanced MDCT, 13/24, 54%; MRI, 11/24, 46%). For cause of neural foraminal stenosis, the accuracies of contrast-enhanced MDCT (46/54, 85%) and MRI (45/57, 79%) were similar. Interobserver agreement on severity of neural foraminal stenosis was moderate to almost perfect for contrast-enhanced MDCT (κ = 0.50-1.00) and MRI (κ = 0.43-1.00). For cause of neural foraminal stenosis, interobserver agreement was moderate to substantial for contrast-enhanced MDCT (κ = 0.52-0.76) but only fair for MRI (κ = 0.23-0.39). Intra observer agreement was very high for severity of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.85; MRI, κ = 0.80) and cause of neural foraminal stenosis (contrast-enhanced MDCT, κ = 0.86; MRI, κ = 1.00). CONCLUSION. Contrast-enhanced MDCT is as accurate as MRI in evaluation of the severity and cause of neural foraminal stenosis and may have better interobserver agreement.

KW - Cervical radiculopathy

KW - Contrast material

KW - CT

KW - Degenerative disease

KW - Disk herniation

KW - Neural foraminal stenosis

UR - http://www.scopus.com/inward/record.url?scp=74749097190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=74749097190&partnerID=8YFLogxK

U2 - 10.2214/AJR.09.2988

DO - 10.2214/AJR.09.2988

M3 - Article

C2 - 20028905

AN - SCOPUS:74749097190

VL - 194

SP - 55

EP - 61

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 1

ER -