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Supine MRI Cobb Measurements for Idiopathic Scoliosis are Linearly Related to Measurements from Standing Plain Radiographs.
MedLine Citation:
PMID:  23429689     Owner:  NLM     Status:  Publisher    
ABSTRACT: Study Design. RetrospectiveObjective. To demonstrate a relationship between adolescent idiopathic scoliosis Cobb angle measurements obtained with standing plain radiographs and standard supine MRI.Summary of Background Data. Patients with adolescent idiopathic scoliosis are exposed to repeated doses of ionizing radiation over the course of their treatment with significant potential long-term health consequences. Supine MR imaging of the spine may allow measurements of coronal plane spinal deformity equivalent to plain radiographs while minimizing exposure to ionizing radiation.Methods. A retrospective chart and radiograph review was conducted for patients with adolescent idiopathic scoliosis. Cobb angle measures were derived from available plain radiographs and MR images taken within 6 months of each other. Pearson correlation and linear regression analysis was utilized to test the relationship between plain radiographic and MRI Cobb measures. Inter- and intra- observer reliability for the Cobb measures was tested with a random sample of 20 patients using intra-class correlation coefficients.Results. Supine MRI images tended to underestimate plain radiograph images by 10 degrees, on average. However, radiographic and MR measures showed a strong positive correlation (r = 0.90 to 0.94) for all curves, structural or nonstructural, and this correlation was not influenced by patient age or BMI. The relationship allowed the development of a simple linear equation for converting MRI measures to radiograph measures with an acceptable absolute error of +/- 5 degrees.Conclusion. Cobb angle measures from supine MR imaging of the spine can reliably be translated to the equivalent radiographic measures with an acceptable range of error. The data suggests that standard supine MRI sequences may be a viable substitute for plain radiographs in the clinical diagnosis and serial evaluation of adolescent idiopathic scoliosis while obviating the associated dangers of ionizing radiation from plain radiographs.
Mark C Lee; Matthew Solomito; Archit Patel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-20
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Assistant Professor in Pediatric Orthopaedic Surgery, Connecticut Children's Medical Center, Department of Orthopaedics, 282 Washington Street Hartford, CT 06106. 2Research Coordinator, Connecticut Children's Medical Center, Department of Orthopaedics, 282 Washington Street Hartford, CT 06106. 3Resident, Department of Orthopaedics, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219.
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