MR Imaging Assessment of Lumbar Intervertebral Disk Degeneration and Age-Related Changes: Apparent Diffusion Coefficient versus T2 Quantitation

Niu, Gang; Yang, Jae Hyuk; Wang, R.; Dang, Shan; Wu, Ed X.; Guo, Yumei

doi:10.3174/ajnr.a2556

Cited by 48 publications

(65 citation statements)

References 42 publications

(83 reference statements)

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“…A relatively larger variation in ADC values was observed for discs belonging to Pfirrmann grade IV in comparison to that of grade II or III. This is consistent with previous observations by other researchers [5,8]. It is suggested that the possible presence of freely moving liquid contained within structural derangements, such as cracks and cavitations, in moderate to severely degenerated discs could have impact on their ADC value, which is otherwise thought to reflect modifications of the nucleus pulposus (NP) matrix content and the integrity of disc matrix via a restricted diffusion mechanism in more normal discs [16].…”

Section: Discussionsupporting

confidence: 85%

“…All previous evaluations of ADC in IVD degeneration have been based on the Pfirrmann classification [5,8,9] or a discrete, researcher-defined 2-3 grades based on T2w appearance of IVD [3,6,7,10]. Mainly due to a large overlapping variation of ADC values observed to exist across such morphology-based degeneration categories, the validity of ADC as a quantitative tool was less than conclusive, despite a strong association observed between ADC and degeneration.…”

Section: Discussionmentioning

confidence: 93%

“…Quantification based on the functional aspects of IVD, such as T1 q - [2], T2-relaxation time [3][4][5], and apparent diffusion coefficient (ADC) [3,[5][6][7][8][9][10], has been utilized in differentiating normal and degenerated discs as well as in detecting diurnal T2 and ADC changes of healthy IVD [11]. Delayed gadolinium (Gd)-enhanced MRI contrast (dGEMRIC) was utilized as a means to quantify the nutrient supply via diffusion mechanism across the vertebral body (VB) endplate and IVD interface as well as within the IVD [8,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework

Bahri

Gardner

et al. 2014

Eur Spine J

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework

Bahri

Gardner

et al. 2014

Eur Spine J

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“…12,13 Most studies in the literature preferred segmentation of NP and AF individually. [28][29][30][31][32]34 In intervertebral disks with Pfirrmann grades I and II, segmenting these structures separately usually makes it possible to distinguish them better. If the degeneration increases to grades III and IV, this distinction becomes more difficult.…”

Section: Discussionmentioning

confidence: 99%

T1ρ and T2 Mapping of the Intervertebral Disk: Comparison of Different Methods of Segmentation

Reis¹,

Salmon

Carvalho³

et al. 2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Intervertebral disk biochemical composition could be accessed in vivo by T1 and T2 relaxometry. We found no studies in the literature comparing different segmentation methods for data extraction using these techniques. Our aim was to compare different manual segmentation methods used to extract T1 and T2 relaxation times of intervertebral disks from MR imaging. Seven different methods of partial-disk segmentation techniques were compared with whole-disk segmentation as the reference standard.

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“…There is a positive correlation of intervertebral disk T2 relaxation times with hydration and, to a lesser extent, with proteoglycan content and a negative correlation with collagen. 75,76 Good correlation between T2 mapping values and water or proteoglycan content in lumbar intervertebral disk has been validated, 76,77 as well as characterization of different tissue compartments within the intervertebral disk based on T2 values (ie, the annulus fibrosus and nucleus pulposus). 78 Painful herniated disks have shown a lower T2 relaxation compared with those without pain.…”

Section: Shah and Rossmentioning

confidence: 99%

Imaging of Degenerative and Infectious Conditions of the Spine

Shah

Ross

2016

Neurosurgery

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Imaging is important in the evaluation of patients with degenerative disease and infectious processes. There are numerous conditions that can manifest as low back pain (LBP) or neck pain in a patient, and in many cases, the cause may be multifactorial. Clinical history and physical examination are key components in the evaluation of such patients; however, physical examination has variable sensitivity and specificity. Although studies have demonstrated that uncomplicated acute LBP and/or radiculopathy are self-limited conditions that do not warrant any imaging, neuroimaging can provide clear anatomic delineation of potential causes of the patient's clinical presentation. Various professional organizations have recommendations for imaging of LBP, which generally agree that an imaging study is not indicated for patients with uncomplicated LBP or radiculopathy without a red flag (eg, neurological deficit such as major weakness or numbness in lower extremities, bowel or bladder dysfunction, saddle anesthesia, fever, history of cancer, intravenous drug use, immunosuppression, trauma, or worsening symptoms). Different imaging modalities have a complementary role in the diagnosis of pathologies affecting the spine. In this review, we discuss the standard nomenclature for lumbar disk pathology and the utility of various clinical imaging techniques in the evaluation of LBP/neck pain for potential neurosurgical management. The imaging appearance of spinal infections and potential mimics also is reviewed. Finally, we discuss advanced neuroradiological techniques that offer greater microstructural and functional information. ABBREVIATIONS: ADC, apparent diffusion coefficient; DTI, diffusion tensor imaging; DWI, diffusionweighted imaging; DOM, diskitis-osteomyelitis; LBP, low back pain; MRM, magnetic resonance myelography; SNA, spinal neuroarthropathy; SPECT, single-positron emission computed tomography; STIR, short tau inversion recovery Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.neurosurgery-online.com). the diagnosis of patients with degenerative and infectious processes affecting the spine, with specific attention to the lumbar spine. NEURORADIOLOGY REVIEW SERIES NEURORADIOLOGY REVIEW SERIES DEGENERATIVE SPINELBP is ubiquitous, affecting up to two-thirds of adults at some period in their lives.3 Imaging, primarily with MRI and CT, is used to evaluate the source of both LBP and neck pain. These imaging modalities commonly identify disk degeneration, disk herniations, and posterior element arthopathy; however, the imaging findings of spine degeneration are present in a high proportion of asymptomatic individuals and increase with age. 5,6 Although many imaged-based degenerative changes are due to the normal aging process, such imaging findings are often interpreted as the cause of the patient's back pain and initiate a cascade of medical and surgical interventions, wh...

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MR Imaging Assessment of Lumbar Intervertebral Disk Degeneration and Age-Related Changes: Apparent Diffusion Coefficient versus T2 Quantitation

Abstract: BACKGROUND AND PURPOSE: T2 and ADC mappings are 2 quantitative MR imaging tools for assessing IVDD. This study aimed to compare these 2 measures in detecting IVDD and its age-related changes.

Cited by 48 publications

References 42 publications

In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework

In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework

T1ρ and T2 Mapping of the Intervertebral Disk: Comparison of Different Methods of Segmentation

Imaging of Degenerative and Infectious Conditions of the Spine

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