The clear differentiation of IVD degeneration and the possible quantification by means of T2 and fast T2* mapping may provide a new tool for follow-up therapy protocols in patients with low back pain.

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Quantitative T2 mapping of the nucleus pulposus of the intervertebral disc in the lumbar spine at 3 T reveals significant differences in discs with herniation and annular tears compared with discs without these abnormalities.

This study demonstrates the feasibility of a combined T2 mapping approach for the facet joints and intervertebral discs using a single axial slab.

Background contextDiurnal changes in T2 values, indicative for changes in water content, have been reported in the lumbar intervertebral discs. However, data concerning short-term T2 changes are missing.PurposeThe purpose of this study was to investigate the short-term effects of unloading on T2 values in lumbar intervertebral discs in vivo.Study designExperimental study with repeated measurements of lumbar discs T2 relaxation time during a period of 38 minutes of supine posture.Patient sampleForty-one patients with acute or chronic low back pain (visual analog scale ≥3).Outcome measuresT2 relaxation time in the intervertebral disc, lumbar lordosis angle, and intervertebral disc height.MethodsForty-one patients (mean age, 41.6 years) were investigated in the supine position using a 3-tesla magnetic resonance system. Sagittal T2 mapping was performed immediately after unloading and after a mean delay of 38 minutes. No patient movement was allowed between the measurements. One region of interest (ROI) was manually placed in both the anterior and the posterior annulus fibrosus (AF) and three ROIs in the nucleus pulposus (NP).ResultsThere was a statistically significant decrease in the anterior NP (−2.7 ms; p<.05) and an increase in T2 values in the posterior AF (+3.5 ms; p<.001). Discs with initially low T2 values in the NP showed minor increase in the posterior AF (+1.6 ms; p<.05), whereas a major increase in the posterior AF was found in discs with initially high T2 values in the NP (+6.8 ms; p=.001). Patients examined in the morning showed no differences, but those investigated in the afternoon showed a decrease in the anterior NP (−5.3 ms; p<.05) and an increase in the posterior AF (+7.8 ms; p=.002). No significant differences were observed in other regions. Correlation analysis showed moderate correlations between the time of investigation and T2 changes in the posterior AF (r=0.46; p=.002).ConclusionsA shift of water from the anterior to the posterior disc regions seems to occur after unloading the lumbar spine in the supine position. The clinical relevance of these changes needs to be investigated.

Almost nothing is known about the condition of the knee joints of multistage ultra-marathon (MSUM) runner. This is first image-based investigation of the femoropatellar joint (FPJ) using a mobile 1.5T MRI accompanying the MSUM TransEurope Foot-Race (TEFR) 64 stages over 4486 km. Twenty-two (20 male) subjects got a knee MRI-protocol at defined measurement intervals during TEFR: T2*-mapping (FLASH T2*-GRE), TIRM, and fat saturated PD -sequence. In the FPJ 12 different regions were evaluated regarding cartilage T2* and thickness changes and cartilage lesions in course of TEFR and a test on possible compounding factors (running burden, BMI, age) was done if being appropriate. No significant changes in cartilage thickness- and T2*-values were found during TEFR. In 8 runners, at least one single cartilage lesion (Grade 2–3) was found at baseline, but no significant race-related adjacent T2*-changes or progress of the defects could be detected. Analyses on compounding factors were negative. In knees with MPP (5) significantly lower adjacent T2*-values were found. The extreme running burden of a MSUM seems not to have a relevant negative influence on the FPJ tissues, even if cartilage lesions are present.