Comparison of computed tomography myelography and magnetic resonance imaging in the evaluation of cervical spondylotic myelopathy and radiculopathy.
METHODS
A cross-sectional retrospective radiologic study.


OBJECTIVE
To establish concordance rates between interpretations of computed tomography myelography and magnetic resonance imaging in patients with degenerative cervical spine disease.


BACKGROUND
Observed discrepancies in interpretation of computed tomography myelography and magnetic resonance imaging question the reliability of comparisons between these two methods.


METHODS
This study blindly and randomly evaluated cervical computed tomography myelography and magnetic resonance imaging in 20 patients referred for clinically diagnosed cervical spondylotic radiculopathy, myelopathy, or both. The discovertebral joints, facet joints, lateral recesses, cord size, spinal canal, and neural foramina also were evaluated with graded scales. All results were subjected to the kappa statistic for strength of agreement.


RESULTS
Agreement for interpretation of the discovertebral junction occurred in 144 of 240 sites (60%), indicating only moderately good intermethod concordance (kappa = 0.44). Intermethod agreement on the characterization of facet joint disease was only moderately good (143 of 160 sites; 89.4%; kappa = 0.52), and on characterization of lateral recess disease was poor (125 of 160 sites; 78.1%; kappa = 0.20). On degree of spinal canal compromise, there was agreement within one grade in 199 of 240 sites (82.9%; kappa = 0.42). Intermethod agreement on neural foraminal encroachment and cord size was only moderately good (kappa = 0.42 and 0.46, respectively). Computed tomography myelography tended to upgrade the spinal canal narrowing and neural foraminal encroachment.


CONCLUSIONS
For most parameters of interpretation, the degree of concordance between computed tomography myelography and magnetic resonance imaging is only moderately good, with discrepancies noted especially in the differentiation of disc and bony pathology. These methods should be viewed as complementary studies.
Shafaie
F F
FF
Mallinckrodt Institute of Radiology, Washington University Medical Center, St. Louis, Missouri, USA.
Wippold
F J
FJ
Gado
M
M
Pilgram
T K
TK
Riew
K D
KD
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods*; D011843:Radiculopathy / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000175:diagnosis*; D013128:Spinal Osteophytosis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed / Q000379:methods*