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The diagnosis of DO preoperatively remains challenging. The current study retrospectively analyzed imaging features of 102 segments with TOLF from 39 patients and proposed a grading system for evaluating DO risk. Logistic regression results showed that unilateral spinal canal occupational rate (UCOR), tram track signs, and C-signs were all risk factors for DO (odds ratios of 5.393, 19.734 and 72.594, respectively). In validation analyses for the TOLF-DO grading system, sensitivity was 76.0% (19\/25), specificity was 91.0% (70\/77), and Youden\u2019s index was 0.66. Thus, implementation of the TOLF-DO grading system has the potential to improve the diagnosis of DO.<\/jats:p>","DOI":"10.1038\/s41598-017-03178-x","type":"journal-article","created":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T11:21:32Z","timestamp":1496316092000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Imaging grading system for the diagnosis of dural ossification based on 102 segments of TOLF CT bone-window data"],"prefix":"10.1038","volume":"7","author":[{"given":"Sheng-yuan","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiong-sheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-bin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lian-shun","family":"Jia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2017,6,7]]},"reference":[{"key":"3178_CR1","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/S0090-3019(98)00051-2","volume":"51","author":"I Nishiura","year":"1999","unstructured":"Nishiura, I., Isozumi, T. & Nishihara, K. et al. 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