title: [Modified MRI short time inversion recovery sequence grading system for lumbar intervertebral disc degeneration].
abstract: OBJECTIVE
  To develop a modified short time inversion recovery (STIR) sequence grading system for lumbar intervertebral disc degeneration based on MRI STIR sequences, and to test the validity and reproducibility of this grading system.
  
  
  METHODS
  A modified 8-level grading system for lumbar intervertebral disc degeneration based on routine sagittal STIR sequences and modified Pfirrmann grading system was developed. Between April 2011 and February 2012, 60 patients with different degrees of lumbar intervertebral disc degeneration were selected as objects of study, including 32 males and 28 females with an average of 50 years (range, 17-85 years). T2 weighted and STIR sequence images were obtained from the lumbar discs of L1, 2-L5, S1 of each object (total, 300 discs). All examinations were analyzed independently by 3 observers and a consensus readout was performed after all data collected. The validity and reproducibility were analyzed by calculating consistent rate and Kappa value.
  
  
  RESULTS
  According to the grading system, there were 0 grade 1, 83 (27.7%) grade 2, 87 (29.0%) grade 3, 66 (22.0%) grade 4, 31 (10.3%) grade 5, 15 (5.0%) grade 6, 12 (4.0%) grade 7, and 6 (2.0%) grade 8. Intra-observer consistency was strong (Kappa value range, 0.822-0.952), and inter-observer consistency was high to strong (Kappa value range, 0.749-0.843). According to the consensus analysis, the total consistent rate was 82.7%-92.7% (mean, 85.6%). A difference of one grade occurred in 13.9% and a difference of two or more grades in 0.5% of all the cases.
  
  
  CONCLUSIONS
  Disc degeneration can be graded by using modified STIR sequence grading system, which can improve the accuracy of grading different degrees of lumbar intervertebral disc degeneration.
authors: Department of Orthopaedics, Affiliated Xinqiao Hospital, the Third Military Medical University, Chongqing, 400037, P.R.China.
authors: Wenqi
authors: W
authors: Pan
authors: Jian
authors: J
authors: Wang
authors: Jie
authors: J
authors: Liu
authors: Yan
authors: Y
authors: Lu
authors: Bo
authors: B
authors: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000473:pathology*; D017116:Low Back Pain / Q000473:pathology; D008159:Lumbar Vertebrae; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult