Comprehensive Grading System of Inflammatory Features of the Lumbar Facet Joints on Magnetic Resonance Imaging.
Comprehensive Grading System of Inflammatory Features of the Lumbar Facet Joints on Magnetic Resonance Imaging.
复制标题
磁共振成像腰椎小关节炎症特征的综合分级系统。
DOI：
10.1097/brs.0000000000004846
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发表时间：
2024
期刊：
影响因子：
3
通讯作者：
Mandell,JacobC
中科院分区：
文献类型：
--
作者：
Acosta,JoséI;Ermann,Joerg;Isaac,Zacharia;DeFilipp,Miriam;Gottreich,JuliaR;Andrew,MichaelN;Chang,Yuchiao;Zampini,JayM;Katz,JeffreyN;Mandell,JacobC
研究设计：回顾性研究目的：我们旨在描述一个基于磁共振成像（MRI）的腰椎小关节炎性特征的分级系统，并评估其可靠性。MRI上的炎症特征通常很明显。虽然已经描述了几个分级系统的小关节病，有很少的数据，这些系统的可靠性，并没有专门集中在炎症features. Materials and Methods. We描述了一个分级系统，评估小关节积液，骨髓水肿和软组织水肿。每个特征从0到3（小关节水肿）或0到2（骨髓水肿强度和程度，软组织水肿强度和程度）分级。四位脊柱专家对50名受试者的双侧L3/4、L4/5和L5/S1节段的MRI进行了分级。所有受试者均有症状性小关节病，并接受治疗性小关节注射。我们评估了每个关节的每个特征的阅片者内和阅片者间的可靠性，并总结了所有6个joints.Results.The平均年龄为56岁（SD = 17），48%为女性。12%的病例发生在L3/4节段，88%发生在L4/5节段，80%发生在L5/S1节段。每个功能的阅片员内可靠性Kappa值范围为0.42至0.81。与此相反，每个特征的阅片者间可靠性Kappa值范围为0.37至0.54。结论：腰椎小关节炎性特征在腰痛患者中经常被注意到。建议的分级系统是可靠的，可以作为一个研究工具，评估这些功能的临床相关性和预后价值的研究。
Study design.Retrospective.Objective.We aimed to describe a magnetic resonance imaging (MRI)-based grading system of inflammatory features of the lumbar facet joints using an atlas and assess its reliability.Summary of Background Data.Chronic low back pain is often caused by facet joint arthropathy. Inflammatory features are often evident on MRI. While several grading systems of facet arthropathy have been described, there is scant data on the reliability of these systems, and none focus exclusively on inflammatory features.Materials and Methods.We describe a grading system that assesses facet joint effusion, bone marrow edema, and soft tissue edema. Each feature was graded from 0 to 3 (facet edema) or 0 to 2 (bone marrow edema intensity and extent, soft tissue edema intensity and extent). Four spine experts graded MRIs of 50 subjects at the bilateral L3/4, L4/5, and L5/S1 levels. All subjects had symptomatic facet arthropathy and received therapeutic facet joint injections. We assessed the intra-reader and inter-reader reliability of each feature at each joint and summarized across all six joints.Results.The mean age of subjects was 56 years (SD= 17), and 48% were female. The injections occurred at the L3/4 level in 12% of cases, at L4/5 in 88%, and at L5/S1 in 80% of cases. The intra-reader reliability kappa’s for each feature ranged from 0.42 to 0.81. In contrast, the inter-reader reliability kappa values for each feature ranged from 0.37 to 0.54.Conclusion.MRI inflammatory features of the lumbar facet joints are often noted in patients with low back pain. The proposed grading system is reliable and could serve as a research tool for studies assessing the clinical relevance and prognostic value of these features.