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Novel Application of the Pfirrmann Disc Degeneration Grading System to 9.4T MRI: Higher Reliability Compared to 3T MRI.
Sher, Idrees; Daly, Chris; Oehme, David; Chandra, Ronil V; Sher, Mustafa; Ghosh, Peter; Smith, Julian; Goldschlager, Tony.
Afiliación
  • Sher I; Department of Neurosurgery, Monash Medical Centre, Clayton, Victoria, Australia.
  • Daly C; Department of Surgery, Monash University, Clayton, Victoria, Australia.
  • Oehme D; The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
  • Chandra RV; Department of Neurosurgery, Monash Medical Centre, Clayton, Victoria, Australia.
  • Sher M; Department of Surgery, Monash University, Clayton, Victoria, Australia.
  • Ghosh P; The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
  • Smith J; Department of Neurosurgery, St Vincent's Hospital, Fitzroy, Victoria, Australia.
  • Goldschlager T; Department of Surgery, Monash University, Clayton, Victoria, Australia.
Spine (Phila Pa 1976) ; 44(13): E766-E773, 2019 Jul 01.
Article en En | MEDLINE | ID: mdl-31205169
STUDY DESIGN: Reliability study. OBJECTIVE: To evaluate the applicability and reliability of 9.4T magnetic resonance imaging (MRI) in the assessment of degenerative disc disease compared with 3T MRI. SUMMARY OF BACKGROUND DATA: MRI is a reliable indicator of biochemical changes in the intervertebral disc (IVD) including hydration status, proteoglycan content, and disc degeneration compared with anatomical and histological studies. High-field 9.4T MRI has been shown to provide superior resolution and anatomical detail. However, it has not been tested against current standard MRI techniques. METHODS: Disc degeneration was initiated in 36 skeletally mature ewes 6 months prior to necropsy via validated surgical IVD injury models using either scalpel injury or drill-bit injury techniques at lumbar spine levels L2/3 and L3/4 with L1/2, L4/5, and L5/6 serving as control discs. All ex vivo IVDs were examined with 9.4T MRI and 3T MRI. All scans were analyzed using the Pfirrmann grading system by four independent observers. Intra- and interobserver reliability was assessed using kappa statistics and Spearman correlation. RESULTS: Inter- and intraobserver agreement for 9.4T MRI was excellent, both at κ 0.91 (P < 0.001). Comparatively, 3T interobserver reliability demonstrated substantial agreement at κ 0.61 (P < 0.001). Complete agreement was obtained in 92.7% to 100% of discs at 9.4T compared with 69.7% to 83.1% at 3T. A difference of one grade or more occurred in 6.7% at 9.4T and 39.3% at 3T. 9.4T MRI scored 97.3% of discs as grade 1 to 2 compared with 71.3% at 3T. 3T MRI tended to over-score the extent of disc degeneration with 28.6% of discs scored as grade 3 or higher compared with 2.7% at 9.4T MRI. CONCLUSION: 9.4T MRI study of IVD degeneration using the Pfirrmann grading system demonstrated excellent inter- and intraobserver reliability. Comparatively, 3T MRI demonstrated a tendency to over score the extent of disc degeneration. This improved reliability of 9.4T MRI holds great potential for its clinical applications. LEVEL OF EVIDENCE: 3.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Degeneración del Disco Intervertebral / Disco Intervertebral / Vértebras Lumbares Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Spine (Phila Pa 1976) Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Degeneración del Disco Intervertebral / Disco Intervertebral / Vértebras Lumbares Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Spine (Phila Pa 1976) Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos