The Clinical Correlation of a New Practical MRI Method for Grading Cervical Neural Foraminal Stenosis Based on Oblique Sagittal Images

Park, Hyojin; Kim, Sam Soo; Han, Chul Hee; Lee, So Yeon; Chung, Eun Chul; Kim, Mi Sung; Kwon, Hee Jin

doi:10.2214/ajr.13.11647

Cited by 28 publications

(32 citation statements)

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“…9 There have been several attempts to quantify the degree of CNFS. [2][3][4][5] Among these, the Kim and Park systems are simple, reproducible, semi-quantitative grading methods. MR evaluation of CNFS should be accurate and easy, as a labour-intensive, time-consuming analysis is not practical in clinical settings.…”

Section: Discussionmentioning

confidence: 99%

“…5 The patient was considered as neurologic signs positive, if the patient demonstrated Spurling sign, Lhermitte sign, decreased response to deep tendon reflex or a positive response on electromyogram. 4 More than one positive neurologic sign and more than one neurologic clinical symptom was considered a positive neurologic manifestation (PNM) of each foraminal stenosis. 5 Clinical symptoms and neurologic signs in the lower extremities or contralateral to the stenosis were not considered a PNM.…”

Section: Clinical Correlationmentioning

confidence: 99%

“…5 Clinical symptoms and neurologic signs in the lower extremities or contralateral to the stenosis were not considered a PNM. 4,5 …”

Section: Clinical Correlationmentioning

confidence: 99%

“…2 During recent years, two semi-quantitative grading systems regarding CNFS have been reported. [2][3][4] Kim et al 3 suggested a grading system based on T 2 weighted axial sections and classification of stenoses using three grades (0, 1 and 2) (the Kim system). Kim grades are calculated from the ratio of the narrowest width of the cervical neural foramen to the width of the extraforaminal nerve root.…”

Section: Introductionmentioning

confidence: 99%

“…A follow-up study indicated that the Park system provides a reliable, reproducible CNFS assessment and also suggested a moderate correlation between the Park system and clinical manifestations. 4 Until now, there have been no studies comparing the Kim and Park grading systems based on the same patient group. The purpose of this study was to compare the reliability, reproducibility and clinical correlation of the Park and Kim systems.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of two MR grading systems for correlation between grade of cervical neural foraminal stenosis and clinical manifestations

Lee¹,

Park²,

Lee³

et al. 2016

BJR

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Objective: To compare the reliability of two recently reported MR grading systems of cervical neural foraminal stenosis (CNFS) and their correlation with clinical manifestations. Methods: We evaluated 188 patients (male : female 5 80 : 108; mean age of 41 years) who visited our institution and underwent oblique sagittal MRI of the cervical spine. Two radiologists evaluated the MRI findings for the presence and grade of CNFS at the narrowest point, with the grading systems (Park, Kim and mKim systems) suggested by Park et al and Kim et al. More than one positive neurologic sign and more than one neurologic clinical symptom was considered a positive neurologic manifestation of each foraminal stenosis. Interobserver agreement between the two readers was analyzed using kappa statistics. Non-parametric correlation analysis (Spearman's correlation) was used to evaluate the correlation coefficients (R) to assess the relationship between CNFS grade and clinical manifestations.Results: Both the Park and mKim systems demonstrated a relatively high correlation (R 5 0.714-0.764) between the CNFS grade and clinical manifestation, while the Kim system yielded a moderate correlation (by Reader 2). The Park and mKim systems demonstrated higher correlation values at the level of C6-7 than C4-5, while the Kim system showed no difference in correlation at the cervical spine level. Conclusion: Both the Park and mKim systems provide a reliable, reproducible CNFS diagnosis, while the Kim system has a slightly inferior reliability. The Park and mKim systems had a similar, relatively high clinical correlation. Advances in knowledge: Grades 2 and 3 of the Park system and Grade 2 in the Kim and mKim systems exhibited a similar clinical significance. Patients with a grade of 0 (using each system) consistently exhibit negative neurologic manifestation.

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Section: Discussionmentioning

confidence: 99%