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Research ArticleSpine Imaging and Spine Image-Guided Interventions

Qualitative Assessment of Cervical Spinal Stenosis: Observer Variability on CT and MR Images

Jeffrey S. Stafira, Jagadeesh R. Sonnad, William T. C. Yuh, David R. Huard, Robin E. Acker, Dan L. Nguyen, Joan E. Maley, Faridali G. Ramji, Wen-Bin Li and Christopher M. Loftus
American Journal of Neuroradiology April 2003, 24 (4) 766-769;

Article Figures & Data

Figures

  • Fig 1.
    Fig 1.

    A and B, CT myelograms. The reviewers were inconsistent in judging stenosis on CT myelograms, and degree of stenosis ranged from mild to severe (A), except in those levels with the most obvious severe stenosis (B).

  • Fig 2.
    Fig 2.

    A, Sagittal T2-weighted MR image demonstrates stenosis at the C4–5, C5–6, and C6–7 levels. The reviewers were inconsistent in determining the level with the most severe stenosis because of multilevel involvement.

    B, Axial gradient-echo MR image. On the basis of this image and the sagittal image (A), degree of stenosis judged by the reviewers was inconsistent and ranged from mild to severe in this case.

Tables

  • TABLE 1:

    CT: Interobserver evaluation of level of cervical stenosis

    PatientRadiologist #1Radiologist #2Radiologist #3Radiologist #4Radiologist #5Radiologist #6
    1C5–C6C5–C6C5–C6C5–C6C4–C5C5–C6
    2C5–C6C5–C6C5–C6C5–C6C5–C6C6–C7
    3C4–C5C5–C6C5–C6C5–C6C6–C7C5–C6
    4C4–C5C4–C5C4–C5C6–C7C4–C5C6–C7
    5C6–C7C5–C6C5–C6C5–C6C5–C6C5–C6
    6C5–C6C4–C5C4–C5C4–C5C4–C5C4–C5
    7Nonenonenonenonenonenone
    8C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5
    9C6–C7C6–C7C5–C67.5C6–C7C6–C7
    10C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7
    11C6–C7C6–C7C5–C6C6–C7C5–C6C6–C7
    12C6–C7C5–C6C5–C6C5–C6C5–C6C6–C7
    13C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    14C6–C7C6–C7C6–C7C6–C7C6–C7C4–C5
    15C5–C6C5–C6C5–C6C5–C6C5–C6C4–C5
    16C3–C4C3–C4noneC6–C7C6–C7none
    17C6–C7C5–C6C5–C6C5–C6C3–C4C6–C7
    18C5–C6C5–C6C6–C7C5–C6C5–C6C5–C6
    19C3–C4C3–C4C3–C4C3–C4C3–C4C3–C4
    20C3–C4C3–C4C3–C4noneC3–C4none
    21C5–C6C5–C6C5–C6C5–C6C5–C6none
    22C3–C4C3–C4C3–C4C3–C4C3–C4C3–C4
    23C5–C6C5–C6C5–C6C5–C6C4–C5C6–C7
    24C6–C7C5–C6C5–C6C4–C5C5–C6C5–C6
    25C3–C4C3–C4C3–C4C4–C5noneC3–C4
    26C6–C7C3–C4C6–C7C6–C7C6–C7C5–C6
    27C5–C6C5–C6C5–C6C5–C6C4–C5C5–C6
    28Nonenonenonenonenonenone
    29C5–C6C5–C6C5–C6C3–C4C4–C5C5–C6
    30C5–C6C5–C6C6–C7C6–C7C6–C7C6–C7
    31NoneC5–C6C5–C6nonenoneC5–C6
    32C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    33C4–C5C4–C5C4–C5C4–C5C4–C5C5–C6
    34C6–C7C6–C7C5–C6C6–C7C6–C7C6–C7
    35C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    36C6–C7C5–C6C5–C6C5–C6C5–C6C5–C6
    37C6–C7C5–C6C6–C7C5–C6C5–C6C6–C7
    38C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
  • TABLE 2:

    CT: Interobserver evaluation of degree of cervical stenosis

    PatientRadiologist #1Radiologist #2Radiologist #3Radiologist #4Radiologist #5Radiologist #6
    1MildModerateModerateModerateModerateMild
    2ModerateSevereMildModerateSevereModerate
    3ModerateModerateModerateModerateModerateModerate
    4ModerateSevereSevereSevereSevereMild
    5ModerateMildMildModerateModerateModerate
    6ModerateMildModerateModerateSevereModerate
    7MildMildMildMildMildMild
    8SevereSevereSevereSevereSevereSevere
    9ModerateModerateModerateMildModerateModerate
    10MildModerateSevereModerateModerateModerate
    11MildMildModerateMildMildMild
    12SevereModerateSevereSevereModerateModerate
    13ModerateSevereSevereModerateSevereMild
    14ModerateSevereSevereModerateSevereModerate
    15ModerateMildModerateModerateModerateMild
    16MildMildModerateMildModerateModerate
    17ModerateSevereMildSevereSevereMild
    18ModerateModerateMildModerateModerateMild
    19ModerateSevereSevereModerateModerateModerate
    20ModerateMildMildMildModerateMild
    21ModerateModerateMildModerateMildMild
    22ModerateMildMildModerateMildMild
    23SevereSevereModerateSevereSevereModerate
    24ModerateMildModerateMildModerateMild
    25ModerateSevereMildSevereSevereMild
    26ModerateModerateMildMildMildMild
    27ModerateModerateModerateModerateMildMild
    28MildMildMildMildMildMild
    29MildModerateMildMildModerateMild
    30MildSevereSevereSevereSevereMild
    31MildMildMildMildMildMild
    32ModerateSevereModerateSevereSevereMild
    33MildMildMildMildModerateMild
    34ModerateModerateModerateModerateMildMild
    35ModerateSevereSevereModerateMildModerate
    36MildModerateMildModerateMildMild
    37ModerateModerateModerateModerateModerateModerate
    38SevereSevereModerateSevereSevereModerate
  • TABLE 3:

    CT: Interobserver evaluation of cause of cervical stenosis

    PatientRadiologist #1Radiologist #2Radiologist #3Radiologist #4Radiologist #5Radiologist #6
    1osteophyteosteophyteosteophytediscosteophytecombination
    2combinationcombinationcombinationcombinationcombinationcombination
    3osteophyteosteophytecombinationcombinationosteophyteosteophyte
    4discdiscdiscosteophytedisccombination
    5osteophyteosteophytecombinationnonediscnone
    6disccombinationdiscdiscdiscdisc
    7nonenonenonenonenonenone
    8combinationosteophyteosteophytecombinationcombinationcombination
    9osteophyteosteophyteosteophyteosteophytecombinationosteophyte
    10discdiscdiscdiscdiscdisc
    11disccombinationosteophytediscosteophyteosteophyte
    12combinationosteophyteosteophyteosteophyteosteophytenone
    13osteophyteosteophyteosteophyteosteophyteosteophyteosteophyte
    14osteophyteosteophyteosteophyteosteophyteosteophytecombination
    15osteophyteosteophyteosteophyteosteophyteosteophytenone
    16osteophyteosteophytenonecombinationosteophytenone
    17osteophyteosteophyteosteophyteosteophyteosteophyteosteophyte
    18osteophytediscosteophytediscdiscnone
    19osteophyteosteophyteosteophyteosteophyteosteophytecombination
    20disccombinationnonenoneosteophytenone
    21osteophyteosteophyteosteophyteosteophyteosteophytenone
    22combinationcombinationosteophytediscdiscosteophyte
    23combinationcombinationosteophytediscdiscosteophyte
    24combinationcombinationosteophytediscdiscosteophyte
    25osteophyteosteophyteosteophytenonenonenone
    26osteophyteosteophyteosteophytenonediscdisc
    27osteophyteosteophyteosteophyteosteophyteosteophyteosteophyte
    28nonenonenonenonenonenone
    29osteophytecombinationcombinationcombinationdiscosteophyte
    30osteophyteosteophyteosteophyteosteophyteosteophyteosteophyte
    31nonecombinationosteophytenonenonedisc
    32combinationcombinationosteophytecombinationdiscnone
    33osteophyteosteophyteosteophyteosteophyteosteophyteosteophyte
    34combinationosteophyteosteophytecombinationosteophytecombination
    35osteophytecombinationcombinationosteophytediscosteophyte
    36osteophyteosteophyteosteophyteosteophyteosteophytenone
    37discdisccombinationdiscdiscosteophyte
    38osteophyteosteophyteosteophyteosteophyteosteophytenone
  • TABLE 4:

    MR: Interobserver evaluation of level of cervical stenosis

    PatientRadiologist #1Radiologist #2Radiologist #3Radiologist #4Radiologist #5Radiologist #6
    1C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5
    2C5–C6C5–C6C5–C6C5–C6C4–C5C4–C5
    3C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    4C5–C6C4–C5C4–C5C4–C5C4–C5C4–C5
    5C5–C6C5–C6C5–C6C5–C6C5–C6C6–C7
    6C4–C5C3–C4C4–C5C3–C4C4–C5C3–C4
    7C6–C7noneC6–C7C6–C7C6–C7none
    8C3–C4C3–C4C3–C4C5–C6C3–C4C3–C4
    9C6–C7C6–C7C6–C7C6–C7C5–C6C6–C7
    10C6–C7C6–C7C6–C7C5–C6C5–C6C6–C7
    11C5–C6C5–C6C5–C6C6–C7C5–C6C5–C6
    12C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7
    13C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    14C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5
    15C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    16C6–C7C3–C4C6–C7C6–C7C6–C7C6–C7
    17C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    18C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    19C5–C6C3–C4C3–C4C3–C4C3–C4C3–C4
    20C3–C4C3–C4C3–C4C3–C4C3–C4C3–C4
    21C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    22C3–C4C3–C4C4–C5C3–C4C3–C4C3–C4
    23C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    24C5–C6C5–C6C4–C5C4–C5C6–C7C5–C6
    25C3–C4C3–C4C3–C4C3–C4C3–C4C4–C5
    26C6–C7C6–C74,5C6–C7C6–C7C6–C7
    27C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    28C6–C7C6–C7nonenonenonenone
    29C5–C6C5–C6C5–C6C4–C5C4–C5C5–C6
    30C5–C6C5–C6C6–C7C3–C4C3–C4C5–C6
    31nonenonenoneC3–C4noneC5–C6
    32C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    33C4–C5C5–C6C5–C6C4–C5C5–C6C5–C6
    34C5–C6C5–C6C5–C6C6–C7C5–C6C5–C6
    35C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    36C5–C6C5–C6C5–C6noneC5–C6C5–C6
    37C5–C6C5–C6C5–C6C6–C7C5–C6C5–C6
    38C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
  • TABLE 5:

    MR: Interobserver evaluation of degree of cervical stenosis

    PatientRadiologist #1Radiologist #2Radiologist #3Radiologist #4Radiologist #5Radiologist #6
    1ModerateModerateSevereModerateModerateModerate
    2ModerateModerateSevereSevereMildSevere
    3SevereSevereSevereModerateSevereModerate
    4ModerateSevereSevereModerateSevereSevere
    5MildModerateMildModerateMildModerate
    6ModerateSevereSevereModerateModerateSevere
    7MildMildMildMildMildMild
    8SevereSevereSevereModerateSevereSevere
    9ModerateModerateModerateMildModerateModerate
    10ModerateModerateModerateModerateMildModerate
    11MildModerateModerateModerateMildMild
    12SevereSevereSevereModerateModerateModerate
    13SevereSevereSevereModerateSevereSevere
    14SevereSevereSevereSevereSevereSevere
    15SevereSevereModerateModerateModerateModerate
    16MildMildMildModerateSevereModerate
    17SevereSevereSevereModerateModerateSevere
    18ModerateModerateSevereMildModerateModerate
    19ModerateModerateModerateModerateModerateModerate
    20ModerateModerateModerateModerateMildModerate
    21ModerateModerateSevereMildMildMild
    22ModerateModerateModerateModerateModerateMild
    23SevereSevereSevereSevereSevereSevere
    24SevereSevereSevereModerateModerateModerate
    25SevereSevereSevereModerateModerateSevere
    26ModerateModerateMildMildMildMild
    27ModerateModerateModerateMildMildMild
    28ModerateMildMildMildMildMild
    29ModerateMildModerateMildMildModerate
    30SevereSevereSevereModerateModerateSevere
    31MildMildMildMildMildMild
    32SevereSevereSevereModerateMildSevere
    33ModerateMildModerateMildMildModerate
    34ModerateMildModerateMildMildMild
    35ModerateMildModerateMildMildMild
    36ModerateMildModerateMildMildMild
    37ModerateModerateSevereMildModerateModerate
    38SevereSevereSevereMildModerateSevere
  • TABLE 6:

    MR: Interobserver evaluation of cause of cervical stenosis

    PatientRadiologist #1Radiologist #2Radiologist #3Radiologist #4Radiologist #5Radiologist #6
    1discdiscdiscdiscDiscdisc
    2disccombinationosteophytecombinationDisccombination
    3combinationosteophyteosteophytecombinationcombinationcombination
    4combinationdiscosteophyteosteophyteosteophytecombination
    5discdiscdiscdiscDisccombination
    6disccombinationdiscdiscDiscdisc
    7combinationnonediscdiscDiscnone
    8combinationosteophytecombinationdiscDisccombination
    9osteophyteosteophyteosteophyteosteophyteosteophytecombination
    10combinationosteophytecombinationosteophyteDiscosteophyte
    11disccombinationcombinationdiscosteophyteosteophyte
    12disccombinationdiscdiscDiscdisc
    13combinationcombinationdisccombinationDisccombination
    14discosteophytediscdiscDisccombination
    15combinationosteophyteosteophytedisccombinationcombination
    16discosteophytecombinationosteophyteDisccombination
    17discdiscdisccombinationDisccombination
    18disccombinationdiscdiscDiscdisc
    19osteophyteosteophytediscosteophyteosteophyteosteophyte
    20discdiscdisccombinationcombinationdisc
    21combinationosteophyteosteophyteosteophyteosteophytecombination
    22disccombinationdiscdiscDiscdisc
    23combinationcombinationcombinationdiscDiscnone
    24discosteophytediscdiscDiscdisc
    25osteophyteosteophyteosteophyteosteophyteosteophytenone
    26disccombinationnoneosteophyteDiscosteophyte
    27osteophyteosteophytecombinationosteophyteosteophytedisc
    28osteophyteosteophytenonenonenonenone
    29osteophyteosteophytediscdiscDisccombination
    30combinationosteophyteosteophytedisccombinationcombination
    31nonenonenonediscnonedisc
    32discdisccombinationdiscDiscdisc
    33osteophyteosteophyteosteophytediscosteophyteosteophyte
    34osteophyteosteophyteosteophytediscDiscdisc
    35combinationcombinationcombinationosteophytecombinationosteophyte
    36combinationosteophyteosteophytenoneDiscnone
    37disccombinationdiscdiscDiscdisc
    38combinationosteophyteosteophytediscDiscnone
  • TABLE 7:

    CT: Intraobserver evaluation of level of cervical stenosis

    PatientRadiologist #1Repeat EvaluationRadiologist #2Repeat EvaluationRadiologist #3Repeat EvaluationRadiologist #4Repeat EvaluationRadiologist #5Repeat EvaluationRadiologist #6Repeat Evaluation
    1C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C4–C5C5–C6C5–C6C5–C6
    2C5–C6C4–C5C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C6–C7C4–C5
    3C4–C5C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C6–C7C5–C6C5–C6C5–C6
    4C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C6–C7C4–C5C4–C5C4–C5C6–C7C4–C5
    5C6–C7C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    6C5–C6C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5
    7nonenonenonenonenonenonenonenonenoneNonenonenone
    8C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5
    9C6–C7C6–C7C6–C7C6–C7C5–C6C5–C6C7–T1C6–C7C6–C7C6–C7C6–C7C6–C7
    10C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7
    11C6–C7C6–C7C6–C7C5–C6C5–C6C5–C6C6–C7C6–C7C5–C6C5–C6C6–C7C6–C7
    12C6–C7C6–C7C5–C6C6–C7C5–C6C5–C6C5–C6C6–C7C5–C6C5–C6C6–C7C6–C7
    13C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    14C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C5–C6C4–C5none
    15C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C4–C5C4–C5
    16C3–C4noneC3–C4C3–C4noneC6–C7C6–C7C6–C7C6–C7C4–C5noneC4–C5
  • TABLE 8:

    CT: Intraobserver evaluation of degree of cervical stenosis

    PatientRadiologist #1Repeat EvaluationRadiologist #2Repeat EvaluationRadiologist #3Repeat EvaluationRadiologist #4Repeat EvaluationRadiologist #5Repeat EvaluationRadiologist #6Repeat Evaluation
    1MMISIMIIIIMM
    2IISSMIISSIII
    3ISISIIISIIIM
    4ISSSSSSSSSMM
    5IIMIMIIIIIIM
    6IIMSIIISSMIM
    7MMMMMMMMMMMM
    8SSSSSSSSSSSI
    9IIISISMIIIIS
    10MIIISSIIIIII
    11MIMMIIMIMMMM
    12SSISSSSSISII
    13ISSSSSISSSMI
    14IISSSIIISSIM
    15IIMIIMISIIMM
    16MMMMIIMMIMII

    • Note.—M indicates mild; I = moderate; S = severe.

  • TABLE 9:

    CT: Intraobserver evaluation of cause of cervical stenosis

    PatientRadiologist #1Repeat EvaluationRadiologist #2Repeat EvaluationRadiologist #3Repeat EvaluationRadiologist #4Repeat EvaluationRadiologist #5Repeat EvaluationRadiologist #6Repeat Evaluation
    1oCoooodoooCo
    2cCccccccccCc
    3oOoococoooOo
    4dDddddodddCd
    5oDoccdndddNd
    6dDccddddddDc
    7nNnnnnnnnnNn
    8cOooocccccCo
    9oOoooooocoOo
    10dDddddddddDd
    11dDcoooddooOo
    12cCodooodooNd
    13oOooooooooOo
    14oOooooooocCn
    15oOooocooooNo
    16oNocnocoooNd

    • Note.—o indicates osteophyte; d = disc; c = combination (disc-osteophyte); n = none.

  • TABLE 10:

    MR: Intraobserver evaluation of level of cervical stenosis

    PatientRadiologist #1Repeat EvaluationRadiologist #2Repeat EvaluationRadiologist #3Repeat EvaluationRadiologist #4Repeat EvaluationRadiologist #5Repeat EvaluationRadiologist #6Repeat Evaluation
    1C4–C5C4–C5C4–C5C5–C6C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5
    2C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C4–C5C4–C5C4–C5C5–C6
    3C5–C6C5–C6C5–C6C5–C6C5–C6C7–T1C5–C6C5–C6C5–C6C5–C6C5–C6C7–T1
    4C5–C6C5–C6C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5C5–C6
    5C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C6–C7C5–C6
    6C4–C5C4–C5C3–C4C3–C4C4–C5C4–C5C3–C4C4–C5C4–C5C4–C5C3–C4C3–C4
    7C6–C7C6–C7noneC6–C7C6–C7C6–C7C6–C7noneC6–C7C6–C7NoneC6–C7
    8C3–C4C3–C4C3–C4C3–C4C3–C4C3–C4C5–C6C3–C4C3–C4C3–C4C3–C4C4–C5
    9C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C5–C6C5–C6C6–C7C6–C7
    10C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C5–C6C6–C7C5–C6C5–C6C6–C7C6–C7
    11C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C6–C7C6–C7C5–C6C6–C7C5–C6C5–C6
    12C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7
    13C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    14C4–C5C4–C5C4–C5C4–C5C4–C5C6–C7C4–C5C4–C5C4–C5C4–C5C4–C5C4–C5
    15C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6C5–C6
    16C6–C7C6–C7C3–C4C3–C4C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7C6–C7
  • TABLE 11:

    MR: Intraobserver evaluation of degree of cervical stenosis

    PatientRadiologist #1Repeat EvaluationRadiologist #2Repeat EvaluationRadiologist #3Repeat EvaluationRadiologist #4Repeat EvaluationRadiologist #5Repeat EvaluationRadiologist #6Repeat Evaluation
    1ISISSSIIIIIS
    2IIISSSSIMISI
    3SSSSSSIISIIS
    4IISSSSIISSSS
    5MIIIMIIMMIII
    6ISSSSIIIISSS
    7MMMMMMMMMMMM
    8SSSSSSIISSSS
    9ISISIIMMIIII
    10ISIIIIIIMIII
    11MIIMIIIMMIMI
    12SSSSSSIIIIIS
    13SSSSSSIISSSS
    14SSSSSSSSSSSI
    15SSSSISIIIIIS
    16MIMMMIIMSIIM

    • Note.—M indicates mild; I = moderate; S = severe.

  • TABLE 12:

    MR: Intraobserver evaluation of cause of cervical stenosis

    PatientRadiologist #1Repeat EvaluationRadiologist #2Repeat EvaluationRadiologist #3Repeat EvaluationRadiologist #4Repeat EvaluationRadiologist #5Repeat EvaluationRadiologist #6Repeat Evaluation
    1dddodcddddDc
    2ddccoccddcCc
    3ccoooococcCc
    4codcooonooCo
    5dcdcddddddCc
    6ddcdddddddDd
    7ccncdddnddNd
    8ccocccdddcCo
    9ooooooooocCn
    10cooocooodcOo
    11dccccoddocOo
    12ddccdddddcDd
    13ccccddccddCo
    14ddoddoddddCd
    15ccococddccCo
    16ddoccoooddCc

    • Note.—o indicates osteophyte; d = disc; c = combination (disc-osteophyte); n = none.

  • TABLE 13:

    Interobserver agreement

    Imaging ModalityLevelDegreeCause
    CT0.500.260.32
    MR0.600.310.22

    • Note.—Data are κ values.

  • TABLE 14:

    Intraobserver agreement

    Imaging ModalityLevelDegreeCause
    CT vs CT0.69 + 0.110.41 + 0.130.55 + 0.18
    MR vs MR0.80 + 0.170.37 + 0.210.40 + 0.17
    CT vs MR0.35 + 0.180.37 + 0.270.15 + 0.17

    • Note.—Data are mean κ values + SD.

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Qualitative Assessment of Cervical Spinal Stenosis: Observer Variability on CT and MR Images
Jeffrey S. Stafira, Jagadeesh R. Sonnad, William T. C. Yuh, David R. Huard, Robin E. Acker, Dan L. Nguyen, Joan E. Maley, Faridali G. Ramji, Wen-Bin Li, Christopher M. Loftus
American Journal of Neuroradiology Apr 2003, 24 (4) 766-769;
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