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Year :2018
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Month :
January-February
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Volume :
7
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Issue :
1
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Page :
RO56 - RO60
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New Magnetic Resonance Imaging Grading System for Lumbar Neural Foramina Stenosis
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Correspondence Address :
Binoj Varghese V, Arun C Babu,
Dr. Binoj Varghese V,
Department of Radiodiagnosis, Amala Institute of Medical
Sciences, Amala Nagar, Thrissur-680055, Kerala, India.
E-mail: drbinojv@yahoo.co.uk
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Introduction: Introduction: Lumbar spine Magnetic Resonance Imaging (MRI) is the most frequently performed MRI procedure. Radiologist’s reporting on qualification of lumbar neural foramen stenosis varies considerably, as there is no widely accepted grading system. We formulated a new MRI grading system comprising three grades of stenosis and normal foramen.
Aim: To evaluate the reliability of new grading system for lumbar neural foramina stenosis.
Materials and Methods: This descriptive study was conducted in the Department of Radiology at Tertiary Care Hospital in mid Kerala, South India between the period of April 2016 to June 2016. The four grades of the new grading system are based on sagittal MRI, relying T1WI. Grade 0 refers to normal neural foramen; Grade 1 refers to mild foraminal stenosis without perineural fat obliteration; Grade 2 refers to moderate foraminal stenosis showing partial perineural fat obliteration and Grade 3 refers to severe foraminal stenosis showing effacement of perineural fat or nerve root compression. We evaluated 762 neural foramina of 127 consecutive patients aged above 50 years with diagnosis of degenerative disc disease after MRI of the lumbar spine. Two general radiologists independently graded L3/4, L4/5 and L5/S1 neural foramina in MRI studies, using the new grading system. One radiologist regarded neural foramina after one month, blinded to all previous grading. Interobserver agreement between the two radiologists and intraobserver agreement of one radiologist for new grading system was calculated using kappa statistics.
Results: Overall inter-rater and intra-rater agreements (?) for new grading system are 0.836 (range: 0.771 to 0.906) and 0.947 (range: 0.907-0.969) respectively.
Conclusion: New grading system is optimal for routine radiologic reporting, as it is simple and reproducible.
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