title: MRI Inter-Reader and Intra-Reader Reliabilities for Assessing Injury Morphology and Posterior Ligamentous Complex Integrity of the Spine According to the Thoracolumbar Injury Classification System and Severity Score.
abstract: OBJECTIVE
  To evaluate spine magnetic resonance imaging (MRI) inter-reader and intra-reader reliabilities using the thoracolumbar injury classification system and severity score (TLICS) and to analyze the effects of reader experience on reliability and the possible reasons for discordant interpretations.
  
  
  METHODS
  Six radiologists (two senior, two junior radiologists, and two residents) independently scored 100 MRI examinations of thoracolumbar spine injuries to assess injury morphology and posterior ligamentous complex (PLC) integrity according to the TLICS. Inter-reader and intra-reader agreements were determined and analyzed according to the number of years of radiologist experience.
  
  
  RESULTS
  Inter-reader agreement between the six readers was moderate (k = 0.538 for the first and 0.537 for the second review) for injury morphology and fair to moderate (k = 0.440 for the first and 0.389 for the second review) for PLC integrity. No significant difference in inter-reader agreement was observed according to the number of years of radiologist experience. Intra-reader agreements showed a wide range (k = 0.538-0.822 for injury morphology and 0.423-0.616 for PLC integrity). Agreement was achieved in 44 for the first and 45 for the second review about injury morphology, as well as in 41 for the first and 38 for the second review of PLC integrity. A positive correlation was detected between injury morphology score and PLC integrity.
  
  
  CONCLUSIONS
  The reliability of MRI for assessing thoracolumbar spinal injuries according to the TLICS was moderate for injury morphology and fair to moderate for PLC integrity, which may not be influenced by radiologist' experience.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
authors.forename: Guen Young
authors.initials: GY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea. ; Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Lim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Sun
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
authors.forename: Yusuhn
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Radiology, SMG-SNU Boramae Medical Center, Seoul 156-707, Korea.
authors.forename: Jee Won
authors.initials: JW
authors.lastname: Chai
authors.affiliation: Department of Radiology, SMG-SNU Boramae Medical Center, Seoul 156-707, Korea.
authors.forename: Sujin
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea. ; Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D017843:Ligamentum Flavum / Q000473:pathology; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000145:classification* / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000473:pathology; D035441:Thoracic Wall / Q000473:pathology; D055815:Young Adult
keywords: Kappa; MRI; Radiologist; Reliability; Thoracolumbar; Trauma