Spinal MRI Reviewer Accuracy Equal Across Training Levels

Posterior ligamentous complex integrity interpreted with accuracy irrespective of training level

FRIDAY, Sept. 30 (HealthDay News) -- Doctors at multiple levels of training can accurately and efficiently interpret the integrity of the posterior ligamentous complex (PLC) on spinal magnetic resonance imaging (MRI), according to a study published in the August issue of The Spine Journal.

Colin G. Crosby, M.D., from the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues evaluated the sensitivity, specificity, and accuracy of physician reviewers with different levels of training to correctly interpret PLC integrity on MRI, compared to intraoperative observation of 45 patients with traumatic spine injuries who underwent operative fixation. The MRI sequences most indicative of the integrity of each PLC component were also assessed.

The investigators found that the surgeons had a sensitivity of 0.83 and accuracy of 0.81. The attending spine surgeons' sensitivity and accuracy were not significantly different from that of the other reviewers, but the specificity was significantly higher compared with the other reviewers. The reviewers reached a 93 percent agreement that injuries to the supraspinous ligament, interspinous ligament, ligamentum flavum, and the cervical facet capsules in the cervical, thoracic, and lumbar spine were best visualized by sagittal short-tau inversion recovery sequences. The reviewers reached a 95 percent agreement that T2 axial sequences were most optimal for visualization of injury to the lumbar facet capsules.

"The evaluation of the PLC on MRI can be accurately and efficiently interpreted by physicians at multiple levels of training," the authors write.

One of the study authors disclosed financial ties to DePuy.

Abstract
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