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  • Title: New MRI grading system for the cervical canal stenosis.
    Author: Kang Y, Lee JW, Koh YH, Hur S, Kim SJ, Chai JW, Kang HS.
    Journal: AJR Am J Roentgenol; 2011 Jul; 197(1):W134-40. PubMed ID: 21700974.
    Abstract:
    OBJECTIVE: The purpose of this study was to propose a new MRI grading system for cervical canal stenosis and to evaluate the reproducibility of the system. MATERIALS AND METHODS: Cervical canal stenosis was classified according to the T2-weighted sagittal images into the following grades: grade 0, absence of canal stenosis; grade 1, subarachnoid space obliteration exceeding 50%; grade 2, spinal cord deformity; and grade 3, spinal cord signal change. The MRI scans of 82 patients (37 men and 45 women; mean age, 65.2 years; range, 60-86 years) were independently analyzed by six radiologists. Interobserver and intraobserver agreements were analyzed using intraclass correlation coefficient (ICC), along with the percentage agreement and kappa statistics. RESULTS: The ICC for interobserver agreement was 0.716-0.802, indicating good-to-excellent agreement. For the distinction among the four grades, the percentage of agreement was 63-64% (κ = 0.60-0.62). The percentage of agreement for the presence of cervical canal stenosis (grade 0 vs grades 1, 2, and 3) was 79-85% (κ = 0.51-0.59). The percentage of agreement for insignificant (grade 0-1) or significant (grade 2-3) stenosis was 81-85% (κ = 0.57-0.66). The percentage of agreement for the presence of spinal cord signal change (grade 0-2 vs grade 3) was 92-95% (κ = 0.70-0.73). The overall intraobserver agreement was excellent, as determined by an ICC of 0.768. CONCLUSION: The new grading system provides a reliable assessment of cervical canal stenosis.
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