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Observer Variation in MRI Evaluation of Patients Suspected of Lumbar Disk Herniation

Jeroen C. van Rijn1, Nina Klemetsö2, Johannes B. Reitsma1, Charles B. L. M. Majoie2, Frans J. Hulsmans2, Wilco C. Peul3, Jan Stam4, Patrick M. Bossuyt1 and Gerard J. den Heeten2

1 Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105AZ, The Netherlands.
2 Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam 1105AZ, The Netherlands.
3 Department of Neurosurgery, Leiden University Medical Center, Leiden 2333ZA, The Netherlands.
4 Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam 1105AZ, The Netherlands.



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  		Fig. 1A. —60-year-old man with right-sided lumbosacral radicular syndrome at level L5–S1. Sagittal spin-echo unenhanced T1-weighted MR image (TR/TE, 500/14) shows foraminal herniation of L4–L5 disk. Arrow indicates left-sided nerve root L4, reported as "possibly no root compression" by one interpreter.

 


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  		Fig. 1B. —60-year-old man with right-sided lumbosacral radicular syndrome at level L5–S1. Axial spin-echo T1-weighted MR image (520/12) shows right-sided nerve root S1 (arrow), reported as "indeterminate" by both interpreters.

 


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  		Fig. 2. —42-year-old man with left-sided lumbosacral radicular syndrome at level L4–L5. Axial spin-echo unenhanced T1-weighted MR image (TR/TE, 520/12) shows right-sided paramedian herniation of L4–L5 disk. Arrow indicates right-sided nerve root L5, reported as "possibly root compression" by both interpreters.

 

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