Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy.


Journal Article

PURPOSE: Intervertebral cervical disc herniation (CDH) is a relatively common disorder that can coexist with degenerative changes to worsen cervicogenic myelopathy. Despite the frequent disc abnormalities found in asymptomatic populations, magnetic resonance imaging (MRI) is considered excellent at detecting cervical spine myelopathy (CSM) associated with disc abnormality. The objective of this study was to investigate the intra- and inter-observer reliability of MRI detection of CSM in subjects who also had co-existing intervertebral disc abnormalities. MATERIALS AND METHODS: Seven experienced radiologists reviewed twice the MRI of 10 patients with clinically and/or imaging determined myelopathy. MRI assessment was performed individually, with and without operational guidelines. A Fleiss Kappa statistic was used to evaluate the intra- and inter-observer agreement. RESULTS: The study found high intra-observer percent agreement but relatively low Kappa values on selected variables. Inter-observer reliability was also low and neither observation was improved with operational guidelines. We believe that those low values may be associated with the base rate problem of Kappa. CONCLUSION: In conclusion, this study demonstrated high intra-observer percent agreement in MR examination for intervertebral disc abnormalities in patients with underlying cervical myelopathy, but differing levels of intra- and inter-observer Kappa agreement among seven radiologists.

Full Text

Duke Authors

Cited Authors

  • Braga-Baiak, A; Shah, A; Pietrobon, R; Braga, L; Neto, AC; Cook, C

Published Date

  • January 2008

Published In

Volume / Issue

  • 65 / 1

Start / End Page

  • 91 - 98

PubMed ID

  • 17532165

Pubmed Central ID

  • 17532165

International Standard Serial Number (ISSN)

  • 0720-048X

Digital Object Identifier (DOI)

  • 10.1016/j.ejrad.2007.04.014


  • eng

Conference Location

  • Ireland