Deep-Learning-Based Computer-Aided Grading of Cervical Spinal Stenosis from MR Images: Accuracy and Clinical Alignment

作者：Zhiling Wang, Xinquan Chen, Bin Liu, Jinjin Hai, Kai Qiao, Zhen Yuan, Lianjun Yang, Bin Yan, Zhihai Su, Hai Lü · 发表于：Bioengineering · 年份：2025 · DOI：10.3390/bioengineering12060604 · 被引用次数：3 · 研究领域：Medical Imaging and Analysis、Spinal Fractures and Fixation Techniques、Spine and Intervertebral Disc Pathology

Objective: This study aims to apply different deep learning convolutional neural network algorithms to assess the grading of cervical spinal stenosis and to evaluate their consistency with clinician grading results as well as clinical manifestations of patients. Methods: We retrospectively enrolled 954 patients with cervical spine magnetic resonance imaging (MRI) data and medical records from the Fifth Affiliated Hospital of Sun-Yat Sen University. The Kang grading method for sagittal MR images of the cervical spine and the spinal cord compression ratio for horizontal MR images of the cervical spine were adopted for cervical spinal canal stenosis grading. The collected data were randomly divided into training/validation and test sets. The training/validation sets were processed by various image preprocessing and annotation methods, in which deep learning convolutional networks, including classification, target detection, and key point localization models, were applied. The predictive grading of the test set by the model was finally contrasted with the grading results of the clinicians, and correlation analysis was performed with the clinical manifestations of the patients. Result: The EfficientNet_B5 model achieved a five-fold cross-validated accuracy of 79.45% and near-perfect agreement with clinician grading on the test set (κ= 0.848, 0.822), surpassing resident–clinician consistency (κ = 0.732, 0.702). The model-derived compression ratio (0.45 ± 0.07) did not differ signif...