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Clinical usefulness of CT-myelogram comparing with the MRI in degenerative cervical spinal disorders: is CTM still useful for primary diagnostic tool?
J Spinal Disord Tech. 2009 Jul; 22(5):353-7.JS

Abstract

STUDY DESIGN

A radiographic review of 50 patients (29 radiculopathy and 21 myelopathy) who had undergone the anterior cervical discectomy and fusion was performed by 3 observers retrospectively.

OBJECTIVE

To compare the accuracy between magnetic resonance imaging (MRI) and postmyelographic computed tomography (CTM) in degenerative cervical spine disease by assessing the degree of interobserver and intraobserver agreement.

SUMMARY OF BACKGROUND DATA

The assessment of degenerative cervical spinal disease is still demanding. Now MRI is accepted as a primary diagnostic tool for degenerative cervical spine disease. Compared with MRI, usage of CTM has diminished, but it is usually reserved for the patients for whom MRI results were ambiguous or technically suboptimal.

METHODS

We retrospectively reviewed MRIs and CTMs of 50 patients (29 radiculopathy and 21 myelopathy) who had undergone the anterior cervical discectomy and fusion procedure. Using an assessment scale, 3 observers examined 5 parameters: spinal canal narrowing, foraminal stenosis, bony abnormality, intervertebral disk herniation, and nerve root compression. The degree of severity was graded using a 4-point scale for each item. Intraobserver, interobserver agreement, and the accentuation of each image were analyzed.

RESULTS

Intraclass correlation coefficiency statistical analysis showed moderate intraobserver agreement (Cronbach's alpha=0.63) and interobserver agreement (0.52). There was no significant difference in intraobserver, interobserver agreement between MRI (0.58) and CTM (0.57). Compared between MRI and CTM, disc abnormality and nerve root compression on MRI and foraminal stenosis and bony lesion on CTM showed better agreement.

CONCLUSIONS

CTM was still useful in diagnosis of the foraminal stenosis and bony lesion comparing with MRI but showed limitation in disc abnormality and nerve root compression. So even though CTM may provide valuable additional information in difficult or ambiguous cases, it also requires universal standards and sound experience for constant and objective information.

Authors+Show Affiliations

Department of Orthopedic Surgery, School of Medicine, Institute for Medical Science, Chonbuk National University Hospital, Chonbuk National University, Jeonju, Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19525791

Citation

Song, Kyung-Jin, et al. "Clinical Usefulness of CT-myelogram Comparing With the MRI in Degenerative Cervical Spinal Disorders: Is CTM Still Useful for Primary Diagnostic Tool?" Journal of Spinal Disorders & Techniques, vol. 22, no. 5, 2009, pp. 353-7.
Song KJ, Choi BW, Kim GH, et al. Clinical usefulness of CT-myelogram comparing with the MRI in degenerative cervical spinal disorders: is CTM still useful for primary diagnostic tool? J Spinal Disord Tech. 2009;22(5):353-7.
Song, K. J., Choi, B. W., Kim, G. H., & Kim, J. R. (2009). Clinical usefulness of CT-myelogram comparing with the MRI in degenerative cervical spinal disorders: is CTM still useful for primary diagnostic tool? Journal of Spinal Disorders & Techniques, 22(5), 353-7. https://doi.org/10.1097/BSD.0b013e31817df78e
Song KJ, et al. Clinical Usefulness of CT-myelogram Comparing With the MRI in Degenerative Cervical Spinal Disorders: Is CTM Still Useful for Primary Diagnostic Tool. J Spinal Disord Tech. 2009;22(5):353-7. PubMed PMID: 19525791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical usefulness of CT-myelogram comparing with the MRI in degenerative cervical spinal disorders: is CTM still useful for primary diagnostic tool? AU - Song,Kyung-Jin, AU - Choi,Byung-Wan, AU - Kim,Gyu-Hyung, AU - Kim,Jung-Ryul, PY - 2009/6/16/entrez PY - 2009/6/16/pubmed PY - 2009/9/4/medline SP - 353 EP - 7 JF - Journal of spinal disorders & techniques JO - J Spinal Disord Tech VL - 22 IS - 5 N2 - STUDY DESIGN: A radiographic review of 50 patients (29 radiculopathy and 21 myelopathy) who had undergone the anterior cervical discectomy and fusion was performed by 3 observers retrospectively. OBJECTIVE: To compare the accuracy between magnetic resonance imaging (MRI) and postmyelographic computed tomography (CTM) in degenerative cervical spine disease by assessing the degree of interobserver and intraobserver agreement. SUMMARY OF BACKGROUND DATA: The assessment of degenerative cervical spinal disease is still demanding. Now MRI is accepted as a primary diagnostic tool for degenerative cervical spine disease. Compared with MRI, usage of CTM has diminished, but it is usually reserved for the patients for whom MRI results were ambiguous or technically suboptimal. METHODS: We retrospectively reviewed MRIs and CTMs of 50 patients (29 radiculopathy and 21 myelopathy) who had undergone the anterior cervical discectomy and fusion procedure. Using an assessment scale, 3 observers examined 5 parameters: spinal canal narrowing, foraminal stenosis, bony abnormality, intervertebral disk herniation, and nerve root compression. The degree of severity was graded using a 4-point scale for each item. Intraobserver, interobserver agreement, and the accentuation of each image were analyzed. RESULTS: Intraclass correlation coefficiency statistical analysis showed moderate intraobserver agreement (Cronbach's alpha=0.63) and interobserver agreement (0.52). There was no significant difference in intraobserver, interobserver agreement between MRI (0.58) and CTM (0.57). Compared between MRI and CTM, disc abnormality and nerve root compression on MRI and foraminal stenosis and bony lesion on CTM showed better agreement. CONCLUSIONS: CTM was still useful in diagnosis of the foraminal stenosis and bony lesion comparing with MRI but showed limitation in disc abnormality and nerve root compression. So even though CTM may provide valuable additional information in difficult or ambiguous cases, it also requires universal standards and sound experience for constant and objective information. SN - 1539-2465 UR - https://www.unboundmedicine.com/medline/citation/19525791/Clinical_usefulness_of_CT_myelogram_comparing_with_the_MRI_in_degenerative_cervical_spinal_disorders:_is_CTM_still_useful_for_primary_diagnostic_tool L2 - https://doi.org/10.1097/BSD.0b013e31817df78e DB - PRIME DP - Unbound Medicine ER -