Comparison of the reliability of computed tomography and magnetic resonance imaging in the evaluation of facet tropism in degenerative cervical spondylolisthesis
Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (1) : 63-67.
Comparison of the reliability of computed tomography and magnetic resonance imaging in the evaluation of facet tropism in degenerative cervical spondylolisthesis
Objectives To determine the reliability of MRI and CT in the assessment of facet tropism of spondylolisthesis levels in degenerative cervical spondylolisthesis. Methods Using a 4-point scale, 3 reviewers blindly and independently graded the severity of facet tropism of 76 cervical facet joints on axial T2-weighted and sagittal T1- and T2-weighted turbo spin echo images and separately on the corresponding axial MRI and CT scans. All results were subjected to the kappa coefficient statistic for strength of agreement. Results When assessing the severity of facet tropism, the weighted kappa coefficients for agreement between MRI and CT grading were 0.76 (P<0.001), MRI grading of facet tropism was identical to the CT grading in 62 of 76 joints (82%), with substantial intermethod concordance. The inter-rater reliability of three reviewer in MRI and CT were 0.61~0.74 and 0.65~0.81 (range k), respectively. CT performed better, with substantial to very good inter-rater reliability than MRI, which had substantial inter-rater reliability. Intra-rater reliability was higher than inter-rater reliability for both CT and MRI. Conclusion When using MRI and CT to assess facet tropism, they all performed excellent, with substantial to very good agreement for both intermethod agreement and inter-rater reliability or intra-rater reliability. This indicates that MRI can reliably determine the presence or degree of facet tropism. Therefore, for comprehensive assessment of facet tropism, an MR scan should not be performed in addition to a CT.
Facet tropism / Degenerative cervical spondylolisthesis / MRI / CT / kappa coefficient statistic
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