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 language | English (US) |
|---|---|
| Pages (from-to) | 55-61 |
| Number of pages | 7 |
| Journal | American Journal of Roentgenology |
| Volume | 194 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2010 |
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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 journal › Article
}
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 -