Ability of magnetic resonance imaging to accurately determine alar ligament integrity in patients with atlanto-occipital injuries
| Autor: | Thomas E Niemeier, Steven M. Theiss, Adam R. Dyas, Gerald McGwin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
lcsh:Diseases of the musculoskeletal system
cervical spine 03 medical and health sciences Categorical analysis 0302 clinical medicine medicine In patient 030222 orthopedics medicine.diagnostic_test business.industry Intraobserver reliability Significant difference cervical trauma Magnetic resonance imaging medicine.anatomical_structure Alar ligament Ligament Surgery Original Article Neurology (clinical) lcsh:RC925-935 business Nuclear medicine 030217 neurology & neurosurgery Kappa Atlanta-occipital dissociation |
| Zdroj: | Journal of Craniovertebral Junction & Spine Journal of Craniovertebral Junction and Spine, Vol 9, Iss 4, Pp 241-245 (2018) |
| ISSN: | 0976-9285 0974-8237 |
| Popis: | Objective: The objective of this study is to evaluate the the reliability of magnetic resonance imaging (MRI) in diagnosing alar ligament disruption in patients with potential atlanto-occipital dissociation (AOD). Materials and Methods: Three-blinded readers performed retrospective review on 6 patients with intra-operative confirmed atlanto-occipital dissocation in addition to a comparison cohort of patients with other cervical injuries that did not involve the atlanto-occipital articulation. Ligament integrity was graded from 1 to 3 as described by Krakenes et al. The right and left ligaments were assessed separately. Inter-observer agreement by patient, by group (AOD vs. non-AOD), and intra-observer agreement was calculated using weighted Cohen's kappa. Results: Interobserver agreement of alar ligament grade for individual patients ranged from slight to fair (κ = 0.05–0.30). Interobserver agreement of alar ligament grade for each group (AOD vs. non-AOD) ranged from fair to substantial (κ = 0.37–0.66). No statistically significant difference in categorical analysis of groups (AOD vs. non-AOD) and grade (0–1 vs. 2–3) was observed. Intraobserver agreement of individual patient's alar ligament grade ranged from moderate to substantial (κ = 0.50–0.62). Conclusion: The use of MRI to detect upper cervical ligament injuries in AOD is imperfect. Our results show inconsistent and unsatisfactory interobserver and intraobserver reliability in evaluation of alar ligament injuries. While MRI has immense potential for detection of ligamentous injury at the craniovertebral junction, standardized algorithms for its use and interpretation need to be developed. |
| Databáze: | OpenAIRE |
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