title: Qualitative assessment of cervical spinal stenosis: observer variability on CT and MR images.
abstract: 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.
authors.affiliation: Department of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Stafira
authors.forename: Jagadeesh R
authors.initials: JR
authors.lastname: Sonnad
authors.forename: William T C
authors.initials: WT
authors.lastname: Yuh
authors.forename: David R
authors.initials: DR
authors.lastname: Huard
authors.forename: Robin E
authors.initials: RE
authors.lastname: Acker
authors.forename: Dan L
authors.initials: DL
authors.lastname: Nguyen
authors.forename: Joan E
authors.initials: JE
authors.lastname: Maley
authors.forename: Faridali G
authors.initials: FG
authors.lastname: Ramji
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Li
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Loftus
mesh_terms: 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