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. 2018 Feb;12(1):94-102.
doi: 10.4184/asj.2018.12.1.94. Epub 2018 Feb 7.

Quantitative Magnetic Resonance Imaging Analysis of the Cervical Spine Extensor Muscles: Intrarater and Interrater Reliability of a Novice and an Experienced Rater

Maryse Fortin  1   2 , Octavian Dobrescu  3 , Peter Jarzem  1   3 , Jean Ouellet  1   3 , Michael H Weber  1   3
Affiliations

Quantitative Magnetic Resonance Imaging Analysis of the Cervical Spine Extensor Muscles: Intrarater and Interrater Reliability of a Novice and an Experienced Rater

Maryse Fortin et al. Asian Spine J. 2018 Feb.

Abstract

Study design: Reliability study.

Purpose: To examine the reliability of novice and experienced raters for measurements of the size and composition of the cervical extensor muscles using a thresholding technique.

Overview of literature: Although some authors have reported on the dependability of magnetic resonance imaging (MRI) measurements of the cervical muscles, there remains some variability regarding intrarater and interrater reliabilities, and few studies have examined the associated measurement error. Whether the rater's experience noticeably influences the reliability and precision of such measurements has also not been examined.

Methods: A sample of 10 patients with cervical pathologies was selected. Muscle cross-sectional area (CSA), functional cross-sectional area (FCSA), and signal intensity of the cervical extensor muscles were acquired from axial T2-weighted MRIs by a novice and an experienced rater. All measurements were obtained twice, at least 5 days apart, while the raters were blinded to all earlier measurements.

Results: Interrater reliability estimates (intraclass correlation coefficients) varied between 0.84 and 0.99 for the novice rater and between 0.94 and 0.99 for the experienced rater, indicating excellent reliability. The standard error of measurement for the novice rater was, however, noticeably higher for all cervical muscle measurements. Most of the interrater estimates showed excellent agreement with the exception of CSA measurement of the semispinalis cervicis at C4-C7 and FCSA measurement of the multifidus and semispinalis cervicis at C4-C7, which showed poor interrater reliability.

Conclusions: The proposed method of investigating cervical muscle measurements was highly reliable; however, novice raters should receive adequate training before using this method for diagnostic, research, and clinical purposes.

Keywords: Magnetic resonance imaging; Methodological study; Musculoskeletal abnormalities; Paraspinal muscles.

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Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Measurement of total cross-sectional area for the MF, SCER, SCAP, and SPL muscles at C2–C3 (A) and C4–C5 (B). The MF and SCER muscles were measured together at the C2–C3 spinal level. MF, multifidus; SCER, semispinalis cervicis; SCAP, semispinalis capitis; SPL, splenius capitis.
Fig. 2
Fig. 2. (A) Axial T2-weighted magnetic resonance imaging image used to acquire cervical muscle measurements. (B) The image shows the application of a signal threshold filter (ImageJ analysis software, ver. 1.43; National Institutes of Health, Bethesda, Maryland, USA) to highlight the fat-free muscle area and obtain the functional cross-sectional area measurement (in red).
See this image and copyright information in PMC

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