title: Clinical correlation of a new and practical magnetic resonance grading system for cervical foraminal stenosis assessment.
abstract: BACKGROUND
  No systematic and quantitative system for evaluation of cervical neural foraminal stenosis (CNFS) has been reported.
  
  
  OBJECTIVE
  To evaluate whether the new magnetic resonance (MR) grading system for CNFS correlates with clinical manifestations and to propose a modified grading system more useful for clinical practice.
  
  
  METHODS
  We examined 356 patients who underwent MR imaging (MRI) of the cervical spine. The presence and grade of cervical foraminal stenosis at the maximal narrowing point were assessed using the new grading system suggested by Kim et al. (Kim system) and a modification of this grading system (modified Kim system) based on T2 axial images. Grade 0: narrowest neural foramen > extraforaminal root; Grade 1: ≤ extraforaminal root; Grade 2: <50% of extraforaminal root. Modified Kim system: Grade 0: >80%, Grade 1: <80% but >50%, Grade 2 as for the Kim system. Results were correlated with clinical manifestations and neurologic physical examination findings (positive neurologic manifestation [PNM]).
  
  
  RESULTS
  Analysis of correlation coefficients (Rs) showed moderate correlation between grades and clinical manifestations using the Kim system (0.484-0.562) and moderate to high correlation between grades and PNMs using the modified Kim system (0.517-0.782).
  
  
  CONCLUSIONS
  The Kim system showed moderate correlation clinical findings, while the modified Kim system still showed moderate but slightly stronger correlation. In both systems, grade 0 could denote negative neurologic manifestations. Although a considerable number of grade 1 and 2 cases in both systems had PNM, fulfilling the criteria for grades 1 and 2 CNFS, it does not perfectly predict PNM.
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University School of Medicine, Bundang Hospital, Republic of Korea parkhiji@kangwon.ac.kr.
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: Eun Chul
authors.initials: EC
authors.lastname: Chung
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Rho
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea.
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Moon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000175:diagnosis*; D055815:Young Adult
keywords: Magnetic resonance (MR); cervical; foramen; spine; stenosis