Comparison of Magnetic Resonance Imaging and Computed Tomography-Myelography for Quantitative Evaluation of Lumbar Intracanalar Cross-Section
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: A comparison of MRI and computed tomography-myelography (CTM) for lumbar intracanalar dimensions. To compare the capability and reproducibility of MRI and CTM in measuring the cross-sectional morphology of intracanalar lesions of the lumbar spine. Materials and Methods: MRI and CTM of lumbar disc levels from 61 subjects with various lumbar spinal diseases were studied. Dural area, dural anteroposterior (AP) diameter, dural right-left diameter, and thickness of the ligamentum flavum were measured by two orthopedic surgeons. Each section was graded by degree of stenosis. Absolute value and intra- and inter-observer correlation coefficients (ICC) of these measurements and the associations between MRI and CTM values were determined. Results: Except for MRI determination of ligament flavum thickness, CTM and MRI and intra- and ICC suggested sufficient reproducibility. When measurements of dural area, dural AP diameter, and RL diameter were compared, values in CTM were significantly (p = 0.01-0.004) larger than those in MRI (CTM/MRI ratios, 119%, 111%, and 105%, respectively). As spinal stenosis became more severe, discrepancies between CTM and MRI in measurements of the dural sac became larger. Conclusion:Both CTM and MRI provided reproducible measurements of lumbar intracanalar dimensions. However, flavum thickness may be more accurately measured by CTM. Because the differences in the measurements between CTM and MRI are very slight and there is very little data to suggest that the precise degree of stenosis is related to symptoms or treatment outcome, the usefulness of the CTM over MRI needs to be confirmed in future studies.
Abstract
Purpose: A comparison of MRI and computed tomography-myelography (CTM) for lumbar intracanalar dimensions. To compare the capability and reproducibility of MRI and CTM in measuring the cross-sectional morphology of intracanalar lesions of the lumbar spine. Materials and Methods: MRI and CTM of lumbar disc levels from 61 subjects with various lumbar spinal diseases were studied. Dural area, dural anteroposterior (AP) diameter, dural right-left diameter, and thickness of the ligamentum flavum were measured by two orthopedic surgeons. Each section was graded by degree of stenosis. Absolute value and intra- and inter-observer correlation coefficients (ICC) of these measurements and the associations between MRI and CTM values were determined. Results: Except for MRI determination of ligament flavum thickness, CTM and MRI and intra- and ICC suggested sufficient reproducibility. When measurements of dural area, dural AP diameter, and RL diameter were compared, values in CTM were significantly (p = 0.01-0.004) larger than those in MRI (CTM/MRI ratios, 119%, 111%, and 105%, respectively). As spinal stenosis became more severe, discrepancies between CTM and MRI in measurements of the dural sac became larger. Conclusion:Both CTM and MRI provided reproducible measurements of lumbar intracanalar dimensions. However, flavum thickness may be more accurately measured by CTM. Because the differences in the measurements between CTM and MRI are very slight and there is very little data to suggest that the precise degree of stenosis is related to symptoms or treatment outcome, the usefulness of the CTM over MRI needs to be confirmed in future studies.
참고문헌 (26)
- Athiviraham A, "Is spinal stenosis better treated surgically or nonsurgically", Clin Orthop Relat Res, 458, pp.90~93 (2007)
- Katz JN, "Degenerative lumbar spinal stenosis. Diagnostic value of the history and physical examination", Arthritis Rheum, 38, pp.1236~1241 (1995)
- Szpalski M, "Lumbar spinal stenosis in the elderly: an overview", Eur Spine J, 12(Suppl 2), pp.S170~S175 (2003)
- Miyamoto M, "Diagnosis and treatment of lumbar spinal canal stenosis", J Nippon Med Sch, 69, pp.583~587 (2002)
- Gunzburg R, "Clinical and psychofunctional measures of conservative decompression surgery for lumbar spinal stenosis: a prospective cohort study", Eur Spine J, 12, pp.197~204 (2003)
- Resnick DK, "Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 6: magnetic resonance imaging and discography for patient selection for lumbar fusion", J Neurosurg Spine, 2, pp.662~669 (2005)
- Yamazaki K, "Postoperative outcome of lumbar spinal canal stenosis after fenestration: correlation with changes in intradural and extradural tube on magnetic resonance imaging", J Orthop Surg (Hong Kong), 10, pp.136~143 (2002)
- Amundsen T, "Lumbar spinal stenosis. Clinical and radiologic features", Spine (Phila Pa 1976), 20, pp.1178~1186 (1995)
- Drew R, "Reliability in grading the severity of lumbar spinal stenosis", J Spinal Disord, 13, pp.253~258 (2000)
- Onel D, "Lumbar spinal stenosis: clinical", radio logic therapeutic evaluation in 145 patients. Conservative treatment or surgical intervention, 1993, pp.18, 291~298
- Bolender NF, "Role of computed tomography and myelography in the diagnosis of central spinal stenosis", J Bone Joint Surg Am, 67, pp.240~246 (1985)
- Gaskill MF, "Lumbar disc disease and stenosis", Radiol Clin North Am, 29, pp.753~764 (1991)
- Speciale AC, "Observer variability in assessing lumbar spinal stenosis severity on magnetic resonance imaging and its relation to cross-sectional spinal canal area", Spine (Phila Pa 1976), 27, pp.1082~1086 (2002)
- Herno A, "Computed tomography findings 4 years after surgical management of lumbar spinal stenosis. No correlation with clinical outcome", Spine (Phila Pa 1976), 24, pp.2234~2239 (1999)
- Dorenbeck U, "Degenerative diseases of the lumbar spine. Comparison of the multiecho data image combination sequence with magnetization transfer saturation pulse versus lumbar myelography", postmyelographic computed tomography, 2004, pp.45, 866~873
- Sather MD, "Spinal subarachnoid hematoma resulting from lumbar myelography", AJNR Am J Neuroradiol, 28, pp.220~221 (2007)
- Bartynski WS, "Lumbar root compression in the lateral recess: MR imaging, conventional myelography, and CT myelography comparison with surgical confirmation", AJNR Am J Neuroradiol, 24, pp.348~360 (2003)
- Rankine JJ, "MRI of lumbar spondylosis: a comparison of sagittal T2 weighted and three sequence examinations", Br J Radiol, 70, pp.1112~1121 (1997)
- Beattie PF, "Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance imaging", Spine (Phila Pa 1976), 25, pp.819~828 (2000)
- 문은수, "Comparison of the Predictive Value of Myelography, Computed Tomography and MRI on the Treadmill Test in Lumbar Spinal Stenosis", Yonsei Medical Journal, 46(6), pp.806~811 (2005), 연세대학교의과대학
- Burr BA, "Fluid-fluid levels in a unicameral bone cyst: CT and MR findings", J Comput Assist Tomogr, 17, pp.134~136 (1993)
- Reul J, "Assessment of the narrow cervical spinal canal: a prospective comparison of MRI, myelography and CT-myelography", Neuroradiology, 37, pp.187~191 (1995)
- Abla AA, "Delayed spinal subarachnoid hematoma: a rare complication of C1-C2 cervical myelography", AJNR Am J Neuroradiol, 7, pp.526~528 (1986)
- Kotilainen E, "Spondylodiscitis: an un-usual complication after lumbar myelography", Joint Bone Spine, 74, pp.113~114 (2007)
- Young DA, "Complication of myelography--tran-section and withdrawal of a nerve filament by the needle", N Engl J Med, 285, pp.156~157 (1971)
- Willén J, "Surgical results in hidden lumbar spinal stenosis detected by axial loaded computed tomog-raphy and magnetic resonance imaging: an outcome study", Spine (Phila Pa 1976), 33, pp.E109~E115 (2008)