title: [Utility of coronal oblique slices in cervical spine MRI: Improved detection of the neuroforamina].
abstract: OBJECTIVE
  Angulated projections are standard in conventional radiography of the cervical spine, but rarely used in magnetic resonance imaging (MRI). As neuroforaminal pathology plays an important role in the etiology of radicular syndromes and may influence an operative approach, the utility of coronal oblique slices in MRI is explored.
  
  
  METHODS
  In a retrospective setting, 25 consecutive patients with neurologically diagnosed cervical monoradiculopathy were identified. T2-weighted sagittal, coronal oblique, and transversal slice orientations were anonymized. Two radiologists and two neurosurgeons independently assessed the cases. Criteria were site, cause, and grading of the neuroforaminal stenosis and the level of confidence on a 100-point visual analog scale (VAS). We computed interrater agreement, sensitivity, and t tests.
  
  
  RESULTS
  Using only one slice orientation, the sensitivity in detecting the relevant neuroforamen was 0.40 for transversal, 0.68 for sagittal, and 0.64 for coronal oblique scans. A combination of the different angulations increased sensitivity and in 4 cases only the coronal oblique scans proved diagnostic. The readers felt significantly more confident in attributing the cause of the pathology on coronal oblique planes (a mean of 72 VAS points, p = 0.0003 vs 58 (sagittal) vs 64 (transversal)). Interrater agreement was significantly better for experienced (kappa 0. 48) than for inexperienced readers (0.32, p = 0.02).
  
  
  CONCLUSIONS
  Adding coronal oblique planes in cervical spine MRI increases sensitivity and confidence in attributing the cause of neuroforaminal pathology. They are regarded as useful by all the readers.
authors: Klinik für Diagnostische und Interventionelle Radiologie, Universitätskliniken Ulm, Einsteinallee 23, 89081, Ulm, Deutschland. Freund-ulm@t-online.de.
authors: W
authors: W
authors: Freund
authors: Neurochirurgie, Nova Clinic Biberach, Biberach, Deutschland.|Neurochirurgie, Universitätskliniken Ulm, Ulm, Deutschland.
authors: S
authors: S
authors: Klessinger
authors: Klinik für Diagnostische und Interventionelle Radiologie, Universitätskliniken Ulm, Einsteinallee 23, 89081, Ulm, Deutschland.|Diagnostische und Interventionelle Neuroradiologie, Universitätskliniken Aachen, Aachen, Deutschland.
authors: M
authors: M
authors: Mueller
authors: Neurochirurgie, Universitätskliniken Ulm, Ulm, Deutschland.
authors: M-E
authors: ME
authors: Halatsch
authors: Klinik für Diagnostische und Interventionelle Radiologie, Universitätskliniken Ulm, Einsteinallee 23, 89081, Ulm, Deutschland.
authors: G
authors: G
authors: Hoepner
authors: Neurologie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland.
authors: F
authors: F
authors: Weber
authors: Neuroradiologie, Universitätskliniken Ulm, Ulm, Deutschland.
authors: B
authors: B
authors: Schmitz
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D056888:Patient Positioning / Q000379:methods*; D011843:Radiculopathy / Q000209:etiology / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013126:Spinal Nerve Roots / Q000473:pathology*; D013130:Spinal Stenosis / Q000150:complications / Q000473:pathology*
keywords: Nerve compression syndromes; Radiculopathy; Spinal cord diseases; Spinal nerves; Three-dimensional imaging