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Can Supine Magnetic Resonance Imaging Be an Alternative to Standing Lateral Radiographs for Evaluating Cervical Sagittal Alignment?

Korean Journal of Neurotrauma 2020년 16권 2호 p.226 ~ 234
배승현, 손동욱, 이수훈, 이준석, 이상원, 송근성,
소속 상세정보
배승현 ( Bae Sung-Hyun ) - Pusan National University Yangsan Hospital Department of Neurosurgery
손동욱 ( Son Dong-Wuk ) - Pusan National University Yangsan Hospital Department of Neurosurgery
이수훈 ( Lee Su-Hun ) - Pusan National University Yangsan Hospital Department of Neurosurgery
이준석 ( Lee Jun-Seok ) - Pusan National University Yangsan Hospital Department of Neurosurgery
이상원 ( Lee Sang-Weon ) - Pusan National University Yangsan Hospital Department of Neurosurgery
송근성 ( Song Geun-Sung ) - Pusan National University Yangsan Hospital Department of Neurosurgery

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.

키워드

Spine; Cervical vertebrae; Supine position; Radiography; Magnetic resonance imaging

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