Lumbar spine: Reliability of MR imaging findings

John A. Carrino, Jon D. Lurie, Anna N.A. Tosteson, Tor D. Tosteson, Eugene J. Carragee, Jay Kaiser, Margaret R. Grove, Emily Blood, Loretta H. Pearson, N. James Weinstein, Richard Herzog

    Research output: Contribution to journalArticlepeer-review

    163 Scopus citations


    Purpose: To characterize the inter- and intraobserver variability of qualitative, non-disk contour degenerative findings of the lumbar spine at magnetic resonance (MR) imaging. Materials and Methods: The case accrual method used to perform this institutional review board-approved, HIPAA-compliant retrospective study was the random selection of 111 interpretable MR examination cases of subjects from the Spine Patient Outcomes Research Trial. The subjects were aged 18-87 years (mean, 53 years ± 16 [standard deviation]). Four independent readers rated the cases according to defined criteria. A subsample of 40 MR examination cases was selected for reevaluation at least 1 month later. The following findings were assessed: spondylolisthesis, disk degeneration, marrow endplate abnormality (Modic changes), posterior anular hyperintense zone (HIZ), and facet arthropathy. Inter-and intraobserver agreement in rating the data was summarized by using weighted κ statistics. Results: Interobserver agreement was good (k = 0.66) in rating disk degeneration and moderate in rating spondylolisthe- sis (k = 0.55), Modic changes (k = 0.59), facet arthropathy (κ = 0.54), and posterior HIZ (κ = 0.44). Interob-server agreement in rating the extent of Modic changes was moderate: κ Values were 0.43 for determining superior anteroposterior extent, 0.47 for determining superior craniocaudal extent, 0.57 for determining inferior antero- posterior extent, and 0.48 for determining inferior cranio- caudal extent. Intraobserver agreement was good in rating spondylolisthesis (κ = 0.66), disk degeneration (κ = 0.74), Modic changes (κ = 0.64), facet arthropathy (κ = 0.69), and posterior HIZ (κ = 0.67). Intraobserver agreement in rating the extent of Modic changes was moderate, with κ values of 0.54 for superior anteroposterior, 0.60 for inferior anteroposterior, 0.50 for superior craniocaudal, and 0.60 for inferior craniocaudal extent determinations. Conclusion: The interpretation of general lumbar spine MR characteristics has sufficient reliability to warrant the further evaluation of these features as potential prognostic indicators.

    Original languageEnglish (US)
    Pages (from-to)161-170
    Number of pages10
    Issue number1
    StatePublished - Jan 2009

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging


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