Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

Sugiura, Kosuke; Tonogai, Ichiro; Matsuura, Tetsuya; Higashino, Kosaku; Sakai, Toshinori; Suzue, Naoto; Hamada, Daisuke; Goto, Tomohiro; Takata, Yoichiro; Nishisho, Toshihiko; Goda, Yuichiro; Sato, Ryosuke; Kondo, Kenji; Tezuka, Fumiaki; Mineta, Kazuaki; Takeuchi, Makoto; Takahashi, Mitsuhiko; Egawa, Hiroshi; Sairyo, Koichi

doi:10.1155/2014/245952

Cited by 9 publications

(12 citation statements)

References 17 publications

(27 reference statements)

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“…38 Nevertheless, the results in this study clearly indicate that this zone is related to the disc degeneration in Case 3, which could be a radiographic marker for disc degeneration. 35–38 Although the nature of the HIZ is still not clear, we speculate that the HIZ might be related to the geometry of degenerated discs. More studies are needed in order to understand this phenomenon.…”

Section: Discussionmentioning

confidence: 91%

“…31 In addition, the higher water content zone predicted in Case 3 (shown in Figure 7D) is consistent with the High Intensity Zone (HIZ) seen in T2-weighted MRI images. 35–38 The HIZ was initially proposed as a marker to diagnose low back pain, 37,39 whereas it was also found in asymptomatic subjects later. 38 Nevertheless, the results in this study clearly indicate that this zone is related to the disc degeneration in Case 3, which could be a radiographic marker for disc degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…(A) Geometry and size of the disc from human lumbar spine (L2–3, male, non-degenerated 35 ) and (B) Schematic of the right–upper quarter of the disc used in the simulations. The cell density in the healthy disc was assumed to be 4000 cells/mm 3 in NP and 9000 cells/mm 3 in AF.…”

Section: Figurementioning

confidence: 99%

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Influences of Nutrition Supply and Pathways on the Degenerative Patterns in Human Intervertebral Disc

Zhu

Gao

Levene

et al. 2016

SPINE

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Study Design Investigation of the effects of the impairment of different nutritional pathways on the intervertebral disc degeneration patterns in terms of spatial distributions of cell density, glycosaminoglycan content, and water content. Objective To test the hypothesis that impairment of different nutritional pathways would result in different degenerative patterns in human discs. Summary of Background Data Impairment of nutritional pathways has been found to affect cell viability in the disc. However, details on how impairment of different nutritional pathways affects the disc degeneration patterns are unknown. Methods A 3D finite element model was used for this study. This finite element method was based on the cell-activity-coupled mechano-electrochemical theory for cartilaginous tissues. Impairment of the nutritional pathways was simulated by lowering the nutrition level at the disc boundaries. Effects of the impartment of cartilaginous endplate-nucleus pulposus (CEP-NP) pathway only (Case 1), annulus fibrosus (AF) pathway only (Case 2), and both pathways (Case 3) on disc degeneration patterns were studied. Results The predicted critical level of nutrition for Case 1, Case 2, and Case 3 were around 30%, 20%, and 50% of the reference values, respectively. Below this critical level, the disc degeneration would occur. Disc degeneration appeared mainly in the NP for Case 1, in the outer AF for Case 2, and in both the NP and inner to middle AF for Case 3. For Cases 1 and 3, the loss of water content was primarily located in the mid-axial plane, which is consistent with the horizontal gray band seen in some T2-weighted MRI images. For the disc geometry used in this study, it was predicted that there existed a High Intensity Zone (for Case 3), as seen in some T2-weighted MRI images. Conclusion Impairment of different nutrition pathways results in different degenerative patterns.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Influences of Nutrition Supply and Pathways on the Degenerative Patterns in Human Intervertebral Disc

Zhu

Gao

Levene

et al. 2016

SPINE

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“…Histograms of non-degenerated IVDs based on T2W-images or T2-maps data should display two well separated peaks, one from AF and one from NP. In the process of IVD degeneration, an increased number of AF fissures are developed that may result in leakage of NP into the AF [20,21]. Hypothetically, such leakage could be characterized by a region of high signal intensity in the otherwise low signal AF.…”

Section: Discussionmentioning

confidence: 99%

MRI histogram analysis enables objective and continuous classification of intervertebral disc degeneration

et al. 2017

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Purpose Magnetic resonance imaging (MRI) is the best diagnostic imaging method for low back pain. However, the technique is currently not utilized in its full capacity, often failing to depict painful intervertebral discs (IVDs), potentially due to the rough degeneration classification system used clinically today. MR image histograms, which reflect the IVD heterogeneity, may offer sensitive imaging biomarkers for IVD degeneration classification. This study investigates the feasibility of using histogram analysis as means of objective and continuous grading of IVD degeneration. Methods Forty-nine IVDs in ten low back pain patients (six males, 25-69 years) were examined with MRI (T2-weighted images and T2-maps). Each IVD was semi-automatically segmented on three mid-sagittal slices. Histogram features of the IVD were extracted from the defined regions of interest and correlated to Pfirrmann grade. Results Both T2-weighted images and T2-maps displayed similar histogram features. Histograms of well-hydrated IVDs displayed two separate peaks, representing annulus fibrosus and nucleus pulposus. Degenerated IVDs displayed decreased peak separation, where the separation was shown to correlate strongly with Pfirrmann grade (P \ 0.05). In addition, some degenerated IVDs within the same Pfirrmann grade displayed diametrically different histogram appearances. Conclusions Histogram features correlated well with IVD degeneration, suggesting that IVD histogram analysis is a suitable tool for objective and continuous IVD degeneration classification. As histogram analysis revealed IVD heterogeneity, it may be a clinical tool for characterization of regional IVD degeneration effects. To elucidate the usefulness of histogram analysis in patient management, IVD histogram features between asymptomatic and symptomatic individuals needs to be compared.

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“…Because migration of fibroblasts and other cells is important for wound healing and AF tissues undergo tears, fissures, and fractures, one function of AF cells may be to respond to damaged areas by migrating toward the wound and initiating the healing process. One area the AF cells may migrate to are high-intensity zones—the areas of AF tissues that are bright on magnetic resonance imaging scan, which represent tears, granulated tissue, and inflammation [28,29]. It has been reported that high-intensity zones contain small round cells and fibroblasts, yet the origins of these cells have not been studied.…”

Section: Discussionmentioning

confidence: 99%

Annulus fibrosus cells express and utilize C-C chemokine receptor 5 (CCR5) for migration

Liu

Zheng

et al. 2017

The Spine Journal

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BACKGROUND CONTEXT Disc degeneration is associated with the progressive loss of the proteoglycan content of the intervertebral disc, decreased matrix synthesis, higher concentrations of proteolytic enzymes, and increased levels of proinflammatory cytokines. In previous studies, we have shown that C-C chemokine ligand (CCL)2, CCL3, and CCL5 are highly expressed by cultured nucleus pulposus (NP) and annulus fibrosus (AF) cells that have been treated by interleukin-1. The major function of these chemokines is to recruit immune cells into the disc. It is unclear if disc cells can respond to these chemokines. Recent studies by Phillips et al. (2015) showed that NP cells express a number of cytokines and chemokine receptors. PURPOSE The purpose of this study is to determine the gene and protein expression of C-C chemokine receptor (CCR)1, CCR2, and CCR5 in NP and AF cells, and to test if these receptors can respond to their ligands in these cells by cell signaling and migration. STUDY DESIGN/SETTING This is an in vitro study. METHODS For RNA, surface expression, and cell signaling studies, human cells were isolated from the NP and AF tissues collected after spine surgery or from donated spine segments (Gift of Hope Human Donor & Tissue Network of Illinois) and cultured in monolayer. The gene expression of human CCR1, CCR2, and CCR5 was analyzed using real-time polymerase chain reaction. The surface expression of CCR1, CCR2, and CCR5 was analyzed using flow cytometry and fluorescently tagged antibodies specific for these proteins. Extracellular signal-regulated kinase (ERK) phosphorylation was analyzed from the cell lysates of NP and AF cells treated with CCL2 and CCL5 for 1 hour using enzyme-linked immunosorbent assay. Migration of primary rabbit AF cells was assayed using 8-μm Corning Transwell inserts in the presence or absence of CCL5. This study was partially funded by a North American Spine Society 2014 Basic Research Grant Award ($50,000). RESULTS RNA analysis showed that gene expression of CCR1, CCR2, and CCR5 was evident in human NP and AF cells (n=6). Only a small population of NP and AF cells expressed CCR1 (1.9% and 1.2%, respectively) and CCR2 (0.8% and 1.4%, respectively) on the cell surface, whereas a larger percentage expressed CCR5 (12.7% and 11.6%, respectively). Significantly higher levels of ERK phosphorylation were detected in AF cells after treatment with CCL5 and not CCL2. Treatment with either chemokine did not cause significantly higher ERK phosphorylation in NP cells. There was an increase in average AF cell migration in the presence of CCL5. The increase was significant when the migration was induced with CCL5 (500 ng/mL) at both 2- and 6-hour time points. CONCLUSIONS CCR5 is expressed at the RNA level and on the cell surface of NP and AF cells. In the presence of CCL5, we detected increased levels of ERK phosphorylation and AF cell migration, suggesting that the CCR5 receptors in AF cells are functional. These data suggest that AF cells may have the ability to migrate in response ...

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Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

Cited by 9 publications

References 17 publications

Influences of Nutrition Supply and Pathways on the Degenerative Patterns in Human Intervertebral Disc

Influences of Nutrition Supply and Pathways on the Degenerative Patterns in Human Intervertebral Disc

MRI histogram analysis enables objective and continuous classification of intervertebral disc degeneration

Annulus fibrosus cells express and utilize C-C chemokine receptor 5 (CCR5) for migration

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