Are T1-Weighted Three-Dimensional Magnetic Resonance Images Inferior to T2-Weighted Images for Diagnosing Lumbar Foraminal Stenosis in the Fifth Lumbar Nerve Root? A Prospective, Comparative Study in Identical Patients.
Lumbar foraminal stenosis
fifth lumbar nerve root
interobserver agreement
intraobserver agreement
reliability
reproducibility
three-dimensional MRI
Journal
Spine surgery and related research
ISSN: 2432-261X
Titre abrégé: Spine Surg Relat Res
Pays: Japan
ID NLM: 101718059
Informations de publication
Date de publication:
27 Sep 2023
27 Sep 2023
Historique:
received:
09
02
2023
accepted:
16
03
2023
medline:
16
10
2023
pubmed:
16
10
2023
entrez:
16
10
2023
Statut:
epublish
Résumé
Imaging analysis of foraminal stenosis in the fifth lumbar (L5) nerve root remains to be a challenge because of the anatomical complexity of the lumbosacral transition. T2-weighted three-dimensional (3D) magnetic resonance images (MRI) have been dominantly used for diagnosis of lumbar foraminal stenosis, while the reliability of T1-weighted images (WI) has also been proven. In this study, we aim to compare the reliability and reproducibility of T1- and T2-weighted 3D MRI in diagnosing lumbar foraminal stenosis (LFS) of the L5 nerve root. In this study, 39 patients with unilateral L5 radiculopathy (20 had L4-L5 intracanal stenosis; 19 had L5-S foraminal stenosis) were enrolled, prospectively. T1- and T2-weighted 3D lumbar MRI were obtained from each patient. T1WI and T2WI were blinded and then separately reviewed twice by four examiners randomly. The examiners were instructed to answer the side of LFS or absence of LFS. The correct answer rate, sensitivity, specificity, and area under the curve were analyzed and compared between T1WI and T2WI. Also, intra- and interobserver agreements were calculated using kappa (κ)-statistics and compared in the same manner. The average correct answer rate, sensitivity, specificity, and area under the curve of the T1WI/T2WI were 84.6%/80.1%, 82.9%/80.3%, 86.3%/81.3%, and 0.846/0.801, respectively. The intraobserver κ-values of the four examiners ranged from 0.692 to 0.916 (average: 0.762) and from 0.669 to 0.801 (average: 0.720) for T1WI and T2WI, respectively. The interobserver κ-values calculated in a round-robin manner (24 combinations in total) ranged from 0.544 to 0.790 (average: 0.657) and from 0.524 to 0.828 (average: 0.652), respectively. As per our findings, T1- and T2-weighted 3D MRI were determined to have nearly equivalent reliability and reproducibility in terms of diagnosing LFS of the L5 nerve root.
Identifiants
pubmed: 37841035
doi: 10.22603/ssrr.2023-0026
pmc: PMC10569809
doi:
Types de publication
Journal Article
Langues
eng
Pagination
436-442Informations de copyright
Copyright © 2023 The Japanese Society for Spine Surgery and Related Research.
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.
Références
J Orthop Sci. 2015 Mar;20(2):287-94
pubmed: 25491380
Spine (Phila Pa 1976). 2009 Oct 15;34(22):2419-23
pubmed: 19829256
J Spine Surg. 2021 Dec;7(4):502-509
pubmed: 35128124
Spine (Phila Pa 1976). 2007 Apr 15;32(8):896-903
pubmed: 17426636
Asian Spine J. 2012 Dec;6(4):291-3
pubmed: 23275815
Asian Spine J. 2009 Jun;3(1):16-20
pubmed: 20404941
J Orthop Sci. 2022 Mar 16;:
pubmed: 35305864
Neuroradiology. 2014 Jun;56(6):453-7
pubmed: 24728286
Spine (Phila Pa 1976). 2012 May 1;37(10):840-4
pubmed: 21971130
Spine (Phila Pa 1976). 2000 Feb 1;25(3):389-94
pubmed: 10703115
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571
Spine (Phila Pa 1976). 1984 Jan-Feb;9(1):31-41
pubmed: 6719255
Korean J Radiol. 2012 Jul-Aug;13(4):403-11
pubmed: 22778561
J Bone Joint Surg Am. 1971 Jul;53(5):891-903
pubmed: 4326746
J Bone Joint Surg Am. 1995 Jan;77(1):32-8
pubmed: 7822353
Semin Ultrasound CT MR. 1993 Dec;14(6):404-13
pubmed: 8297633
AJR Am J Roentgenol. 2009 May;192(5):1392-6
pubmed: 19380567
J Orthop Sci. 2001;6(2):101-9
pubmed: 11484093
Spine (Phila Pa 1976). 2002 Mar 15;27(6):E169-73
pubmed: 11884922
Spine J. 2017 Aug;17(8):1074-1081
pubmed: 28366688
Spine (Phila Pa 1976). 1996 May 1;21(9):1005-9
pubmed: 8724082
AJR Am J Roentgenol. 2010 Apr;194(4):1095-8
pubmed: 20308517