Evolution of the infant spinal column: evaluation with MR imaging.

Abstract

The appearance of the normal lumbar spinal column was examined in spinal magnetic resonance images obtained in 50 pediatric patients aged 2 years or less. The ossification centers of the developing vertebral bodies, the cartilage, and the disks were studied with a 1.5-T imager by using both short- and long-repetition-time spin-echo sequences. Many of the structures of the spine were noted to undergo dynamic changes in appearance, both in signal intensity and in morphologic characteristics, with growth. The vertebrae and cartilage, especially, transform markedly in infancy and proceed through three characteristic stages of evolution. Stage I, from birth to 1 month of age, is characterized by markedly hypointense ossification centers and hyperintense, prominent cartilage. Stage II, from approximately 1 to 6 months of age, is characterized by increasing signal intensity in the ossification centers, progressing from the endplates in, and decreasing prominence of the cartilage, Stage III, from approximately 7 months of age on, is characterized by increasingly rectangular and centrally intense vertebral bodies and diminishing cartilage. The variability of the signal intensities, with that of muscle used as the standard, and morphologic characteristics of different components of the spine at different stages of development can create significant confusion. Careful analysis, however, permits one to follow the evolution of the lumbar spine and to date it on the basis of its appearance.

SMD Kozlowski type caused by p.Arg594His substitution in TRPV4 reveals abnormal ossification and notochordal remnants in discs and vertebrae

“…1, Table I). This value is in the range of normal for lumbar vertebral bodies in neonates (0.25 – 0.50), while for age group 18–24 months, corresponding with our patient, varies from minimal to 0.125 [She et al, 1991]. The vertebral bodies of the cervical and thoracic spine contain cartilage layers which are much thicker than those of the lumbar region, with mean C/O values of 0.91 and 0.50, respectively (Table I).…”

“…The cartilaginous structures of the carpal region were studied with a cartilage dedicated sequence (T1W image with WatSc - water selective cartilage scan - sequence - TR 20 msec, TE 5,3 msec; voxel 0.23 × 0.23 × 0.25; FOV 12 × 120 mm). The cartilage thickness of vertebral bodies, ossification centers and discs was evaluated in sagittal plane of the cervical, thoracic and lumbar spine and analyzed quantitatively with the method described by She et al [1991]. The cartilage was defined as “the hyaline cartilage, which enveloped the ossification center and formed the endochondral growth layer”.…”

“…The height (thickness) of discs and vertebral bodies was also measured. The vertebral body was defined as “the ossification center together with superior and inferior hyaline cartilage layers.” The disc was defined as “the intervertebral structure between the hyaline cartilage layers of two adjacent vertebrae.” The ratio of the disc to vertebral body height was calculated and compared with data from normal infants [Sze at al., 1991]. …”

Imaging of Back Pain in Children

“…47 Low signal intensity, however, is not a reliable marker in children younger than 5 years of age because bone marrow in toddlers and infants may still have active hematopoiesis (red marrow), which typically exhibits low signal intensity on T1-weighted images. 111 Moreover, following the administration of gadolinium, bone marrow in young children can enhance heterogeneously and should not be confused with tumor infiltration. 47 Pathologic vertebral compression fractures can be a manifestation of acute lymphoblastic leukemia in childhood, 112,113 secondary to severe osteoporosis and occurring in 1%-7% of patients diagnosed with this cancer.…”

Changes in T2 Relaxation Times Associated with Maturation of the Human Intervertebral Disk

“…4 MR imaging reveals changes in the intervertebral disk in the first 2 decades of life. [5][6][7][8][9] The intervertebral disk in the neonate is characterized by high signal intensity in T2-weighted images except in the peripheral annulus fibrosus, which has a low signal intensity sharply demarcated from the region of higher signal intensity. 5 In the adult, the disk has a less homogeneous region of high signal intensity that is less well differentiated from the surrounding outer annulus fibrosus.…”