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17.12.2016 | Musculoskeletal

Diagnostic accuracy of contemporary multidetector computed tomography (MDCT) for the detection of lumbar disc herniation

verfasst von: S. Notohamiprodjo, R. Stahl, M. Braunagel, P. M. Kazmierczak, K. M. Thierfelder, K. M. Treitl, S. Wirth, M. Notohamiprodjo

Erschienen in: European Radiology | Ausgabe 8/2017

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Abstract

Objectives

To evaluate the diagnostic accuracy of multidetector CT (MDCT) for detection of lumbar disc herniation with MRI as standard of reference.

Methods

Patients with low back pain underwent indicated MDCT (128-row MDCT, helical pitch), 60 patients with iterative reconstruction (IR) and 67 patients with filtered back projection (FBP). Lumbar spine MRI (1.5 T) was performed within 1 month. Signal-to-noise ratios (SNR) of cerebrospinal fluid (CSF), annulus fibrosus (AF) and the spinal cord (SC) were determined for all modalities. Two readers independently rated image quality (IQ), diagnostic confidence and accuracy in the diagnosis of lumbar disc herniation using MRI as standard of reference. Inter-reader correlation was assessed with weighted κ.

Results

Sensitivity, specificity, precision and accuracy of MDCT for disc protrusion were 98.8%, 96.5%, 97.1%, 97.8% (disc level), 97.7%, 92.9%, 98.6%, 96.9% (patient level). SNR of IR was significantly higher than FBP. IQ was significantly better in IR owing to visually reduced noise and improved delineation of the discs. κ (>0.90) was excellent for both algorithms.

Conclusion

MDCT of the lumbar spine yields high diagnostic accuracy for detection of lumbar disc herniation. IR improves image quality so that the provided diagnostic accuracy is principally equivalent to MRI.

Key Points

• MDCT is an accurate alternative to MRI in disc herniation diagnosis.

• By IR enhanced image quality improves MDCT diagnostic confidence similar to MRI.

• Advances in CT technology contribute to improved diagnostic performance in lumbar spine imaging.

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Titel: Diagnostic accuracy of contemporary multidetector computed tomography (MDCT) for the detection of lumbar disc herniation
verfasst von: S. Notohamiprodjo
R. Stahl
M. Braunagel
P. M. Kazmierczak
K. M. Thierfelder
K. M. Treitl
S. Wirth
M. Notohamiprodjo
Publikationsdatum: 17.12.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4686-7

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Diagnostic accuracy of contemporary multidetector computed tomography (MDCT) for the detection of lumbar disc herniation