Can Supine Magnetic Resonance Imaging Be an Alternative to Standing Lateral Radiographs for Evaluating Cervical Sagittal Alignment?
10.13004/kjnt.2020.16.e18
- Author:
Sung Hyun BAE
1
;
Dong Wuk SON
;
Su Hun LEE
;
Jun Seok LEE
;
Sang Weon LEE
;
Geun Sung SONG
Author Information
1. Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Publication Type:Clinical Article
- From:Korean Journal of Neurotrauma
2020;16(2):226-234
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:Recently, many studies have reported that cervical alignment is related to clinical outcomes. However, poor visibility of anatomical structures during X-ray (XR) imaging limits accurate measurements. In supine magnetic resonance (MR) imaging, the boundary of the anatomical structure is clear, but the correlation to XR images taken in a standing position is problematic. In this study, we evaluated the agreement of sagittal alignment parameters between MR and XR measurements.
Methods:We retrospectively reviewed 268 patients. Cervical sagittal parameters were measured using XR and MR images, and their relationships were evaluated using Pearson's correlation, paired t-tests, and 2-way random, single score intraclass correlation coefficient (ICCs) (2,1). Using simple linear regression analysis, MR results were converted to the expected value (MR-E). The subsequent comparison of MR-Es with XRs was used to examine whether MR-Es could replace XRs when the measurement difference was less than 2 mm or 2°.
Results:The correlation between the MR and XR measurements was high, but ICCs showed low reliability. All parameters were significantly different between XR and MR measurements in paired t-tests. Converting the MR values eliminated the t-test differences between MR-Es and XRs, but did not affect correlations and ICCs. The replacement ratio included the Cobb angle: 20.3%, T1: 27.1%, the sagittal vertical axis: 17.6%, C1–2: 29.7%, and C2: 16.0%.
Conclusion:These results indicate that supine MR measurements could not replace upright XR measurements.
