Degenerative Marrow (Modic) Changes on Cervical Spine Magnetic Resonance Imaging Scans Prevalence, Inter- and Intra-Examiner Reliability and Link to Disc Herniation
Degenerative Marrow (Modic) Changes on Cervical Spine Magnetic Resonance Imaging Scans Prevalence, Inter- and Intra-Examiner Reliability and Link to Disc Herniation
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DOI：
10.1097/brs.0b013e3181ef6a1e
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发表时间：
2011-06-15
期刊：
影响因子：
3
通讯作者：
Hodler, Juerg
中科院分区：
文献类型：
--
作者：
Mann, Eugen;Peterson, Cynthia K.;Hodler, Juerg
研究设计.颈椎Modic改变（MCs）的患病率和可靠性研究。评估MCs诊断和分类的患病率和可靠性及其与颈椎椎间盘突出（DH）的关系。在MRI上可以看到脊柱的退行性骨髓（Modic）变化，有一些证据将其与疼痛联系起来。许多研究已发表的MC在腰椎，但只有一个小的患病率研究集中在MCs在颈椎已被删除。回顾性分析了500例50岁以上患者的颈部磁共振成像（MRI）扫描，以了解MC和DH的患病率、类型和位置。由第二名观察者独立分析200个相同的扫描，以评估观察者间诊断的可靠性，1个月后由同一名观察者重新评估100个，以评估观察者内的可靠性。采用SPSS软件和Kappa统计分析量表的信度和效度。计算DH与MC的危险度比较。426例患者（85.2%）符合入选标准。在40.4%的患者中观察到MC（占所有运动节段的14.4%）。4.3%为1型，10.1%为2型。78.2%的患者（13.3%的运动节段）出现DH。MC和DH最常见于C5/6和C6/7。椎间盘突出与MC呈正相关（RR = 2.4）。可靠性显示观察者间（k - 0.54）为中等偏上，观察者内一致性（k - 0.82）接近完美。MCs的患病率较高，以2型为主。C5/6和C6/7水平受影响最大。MC患者更有可能在同一水平上出现DH。MC 2型占优势。分类是可靠的。
Study Design. A prevalence and reliability study of Modic changes (MCs) in the cervical spine.Objective. To assess the prevalence and reliability of diagnosing and classifying MCs and their relationship to disc herniations (DHs) in the cervical spine.Summary of Background Data. Degenerative marrow (Modic) changes in the spine can be seen on MRI with some evidence linking them to pain. Many studies have been published on MCs in the lumbar spine, but only one small prevalence study focusing on MCs in the cervical spine has been reported.Methods. The cervical magnetic resonance imaging (MRI) scans of 500 patients over the age of 50 were retrospectively evaluated for the prevalence, type, and location of MCs and DHs. Two hundred of these same scans were independently analyzed by a second observer to evaluate interobserver reliability of diagnosis with 100 re-evaluated by the same observer 1 month later to assess intraobserver reliability. The SPSS program and Kappa statistics were used to assess prevalence and reliability. The risk ratio comparison of DH and MC was calculated.Results. Four hundred and twenty-six patients (85.2%) met the inclusion criteria. MCs were observed in 40.4% of patients (14.4% of all motion segments). A 4.3% were type 1 and 10.1% were type 2. DH were seen in 78.2% of patients (13.3% of motion segments). Both MC and DH were most frequently observed at C5/6 and C6/7. Disc extrusions were positively associated with MC (RR = 2.4). The reliability showed an upper moderate interobserver (k - 0.54) and an almost perfect intraobserver agreement (k - 0.82).Conclusion. A high prevalence of MCs was observed with type 2 predominating. The C5/6 and C6/7 levels are most effected. Patients with MC are more likely to have a DH at the same level. MC type 2 predominates. The classification is reliable.