Clinical and Morphological Findings of Disc Herniation by use of Different MRI Sequences by Different Observers

Abstract

Background and Aim: Although MRI is the preferred method with high diagnostic sensitivity for disc herniation, definitive diagnosis based on MRI image interpretation is still a major challenge. The aim of this study was to evaluate the clinical and morphological findings in different MRI sequences and then assessment of the agreement between different observers. Materials and Methods: In this descriptive-analytical study, different MRI sequences of 224 patients with disc herniation were analyzed and diagnosed separately by two radiologists. The morphological type of disc herniation and the location of the involved disc were diagnosed and finally, the diagnostic agreement between the observers was assessed. Results: A total of 224 patients (124 women and 100 men) with disc herniation were included in the study. On average 40% of the cases were bulge, 38% protrusion, 13% extrusion and 9% sequestration. There was complete agreement between the observers in the determination of anatomical location, but in regard to morphological type, we found a kappa agreement coefficient of 0.45 between the observers. Conclusion: T1 weight sequence is helpful in the diagnosis of the bulging hernia. The agreement between the observers was moderate (k = 0.45) and there was no agreement between the physicians on the morphological level of the extrusion and sequestration hernia. Use of other diagnostic methods besides MRI, integrated and continuous training of methods for interpreting MRI images based on Best Evidence Medical Education are recommended.

Keywords

• intervertebral disc herniation
• magnetic resonance imaging (mri)
• inter-observer agreement
• disc herniation level
• mri sequence