Qualitative assessment of cervical spinal stenosis: observer variability on CT and MR images.
OBJECTIVE
Several studies have been undertaken to validate quantitative methods of evaluating cervical spinal stenosis. This study was performed to assess the degree of interobserver and intraobserver agreement in the qualitative evaluation of cervical spinal stenosis on CT myelograms and MR images.


METHODS
Cervical MR images and CT myelograms of 38 patients were evaluated retrospectively. Six neuroradiologists with various backgrounds and training independently assessed the level, degree, and cause of stenosis on either MR images or CT myelograms. Unknown to the evaluators, 16 of the patients were evaluated twice to determine intraobserver variability.


RESULTS
Interobserver agreement among the radiologists with regard to level, degree, and cause of stenosis on CT myelograms showed kappa values of 0.50, 0.26, and 0.32, respectively, and on MR images showed kappa values of 0.60, 0.31, and 0.22, respectively. Intraobserver agreement with regard to level, degree, and cause of stenosis on CT myelograms showed mean kappa values of 0.69, 0.41, and 0.55, respectively, and on MR images showed mean kappa values of 0.80, 0.37, and 0.40, respectively.


CONCLUSIONS
MR imaging and CT myelographic evaluation of cervical spinal stenosis by using current qualitative methods results in significant variation in image interpretation.
Stafira
Jeffrey S
JS
Department of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
Sonnad
Jagadeesh R
JR
Yuh
William T C
WT
Huard
David R
DR
Acker
Robin E
RE
Nguyen
Dan L
DL
Maley
Joan E
JE
Ramji
Faridali G
FG
Li
Wen-Bin
WB
Loftus
Christopher M
CM
D002574:Cervical Vertebrae / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D009192:Myelography; D015588:Observer Variation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013117:Spinal Cord Compression / Q000145:classification / Q000175:diagnosis*; D013130:Spinal Stenosis / Q000145:classification / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed