目的 比较形态学法与硬膜囊面 积法(DSCA)在评价腰椎管狭窄(LSS)中的 可靠性和组间关联。方法 由两名高年资 主治医师独立地分析2014年9月-2014年 11月于就诊的82例LSS的术前MRI，并分别 利用两种方法对L2/3、L3/4、L4/5间盘层 面的椎管狭窄程度进行分级。利用Kappa 统计值来分析诊断的一致性。利用皮尔 森相关和箱线图来分析两种方法的相关 性。结果 两种方法观察者间K值分别为 0.69(0.61-0.77)、0.65(0.56-0.74)， DSCA法观察者内K值分别为0.77(0.60- 0.74)、0.80(0.66-0.93)。形态法观察 者内K值分别为0.78(0.65-0.92)、0.81 (0.68-0.94)。两种方法的相关系数为 0.81。形态学C级和D级狭窄的LSS硬膜囊 面积小于75mm2 。结论 硬膜囊面积法与形 态学法的观察者内和观察者间的一致性良 好，两种方法组间关联强。两种方法均可 以评价MRI中的腰椎管狭窄。

Objective The aim of this study is to compare two different methods for assessing LSS on MRI and study their reliability and intercorrelation. Methods On pretreatment MRI of 82 patients, two experienced radiologists independently classified level L2/ L3, L3/L4 and L4/L5 as no, relative or significant stenosis using both methods. Agreement was analyzed by weighted Kappa. The correlation between the two methods was analysed using Spearman correlation, and visualized in a box plot. Results The interobserver agreement (95 % CI) was 0.69(0.61-0.77) and 0.65 (0.56-0.74), respectively. The intraobserver agreements for DSCA were 0.77 (0.60-0.74) and 0.80 (0.66-0.93). On morphological grading A-D it was 0.78 (0.65–0.92) and 0.81 (0.68- 0.94). The correlationcoefficient between the two methods was 0.85 (p\0.001). Grades C and D were under the limit value for significant stenosis using the DSCA. Conclusion The study shows that the inter- and intraobserver agreements of DSCA and morphological grading A-D were acceptable and their intercorrelation is strong. Both methods may be used in the MRI evaluation of LSS.