Degenerative endplate changes of the lumbosacral spine: Dynamic contrast‐enhanced MRI profiles related to age, sex, and spinal level

Abstract

Purpose: To investigate differences in perfusion profiles between degenerative endplate marrow changes and normal vertebral marrow in relation to spinal level, age, and sex with dynamic contrast-enhanced magnetic resonance imaging (DCE MRI).Materials and Methods: Ninety-two consecutive patients referred for evaluation of low back pain or sciatica, without history of malignant or chronic disease, underwent conventional and DCE MRI of the lumbosacral spine. Fifty-two of them demonstrated degenerative endplate marrow changes. Regions of interest were placed on sites of normal marrow (group A) and degenerative changes (group B) on subtracted images. Fitted time-intensity curves (fTICs) were generated and evaluated for curve pattern. Both groups were stratified into upper (L1-L2) and lower (L3-I1) levels, males and females younger or older than 50 years. Perfusion parameters were calculated and statistically compared for both groups and subgroups. Receiver operator curve (ROC) analysis was also performed.Results: Two fTIC patterns were identified. Perfusion parameters of degenerative changes and normal marrow differed significantly, even when groups were stratified for spinal level, age, and sex (P < 0.05). A time to peak value >108 seconds was characteristic for degenerative changes with sensitivity 69.5% and specificity 84.6%.Conclusion: DCE MRI profiles of degenerative endplate marrow changes of the lumbosacral spine differ significantly from normal marrow regardless of spinal level, age, or sex.

Functional and molecular MRI of the bone marrow in multiple myeloma

“…35 In older subjects with prominent fatty marrow, the curve shows a relatively flat enhancement slope and very low maximal enhancement followed by a plateau or an almost imperceptible washout. In subjects with a higher proportion of red marrow, the curve displays a steeper enhancement slope, higher maximum enhancement and a washout effect [36][37][38] ( Figure 6). Studies evaluating normal marrow perfusion using semi-quantitative indices derived from TICs produced with the region of interest (ROI) method, have shown that maximum enhancement (E max ) Figure 6.…”

Perfusion parameters analysis of the vertebral bone marrow in patients with Ph1− chronic myeloproliferative neoplasms (PhnegMPN): A dynamic contrast‐enhanced MRI (DCE‐MRI) study

“…At a final step, the 50 discrete point DCE curves obtained from each ROI were fitted by means of a non-linear regression method based on the Marquardt algorithm (19), and to an exponentially modified Gaussian (EMG) equation (16,20,21):…”

“…Time to peak (TTPK; expressed in sec) and time to maximum slope (TMSP; expressed in sec) values were obtained from the X-axis of the first derivative function d(DCE)/dt ¼f(t), (Fig. 1), (16,20,21,24). The maximum net contrast enhancement (CE max ; expressed as a.u.)…”

“…WIN and WOUT are expressed in (sec À1 ) units; TMSP is measured in (sec) units and reflects the specific time point where WIN is maximum. TTPK is expressed in (sec) units and reflects the specific time point where contrast enhancement is maximum (16,20,21). WTSP ratio is expressed in (sec…”

Non-invasive quantification of age-related changes in the vertebral endplate in rats using in vivo DCE-MRI

“…Recent advancements in DCE-MRI have made this technique feasible for a non-invasive in vivo longitudinal quantification of intervertebral disc changes in both normal and experimental animal models. DCE-MRI, which utilizes high-field magnetic systems and high-resolution magnet systems, can detect significant changes in the signal enhancement time course in the region of interest (ROI) of intervertebral discs by using the contrast agent gadopentetate dimeglumine [ 6 , 7 ].…”