Tissue characterization of symptomatic and asymptomatic disc herniations by quantitative magnetic resonance imaging

Abstract

The purpose of this investigation was to determine differences in tissue composition of symptomatic and asymptomatic disc herniations as reflected in T1 and T2 relaxation times (quantitative magnetic resonance imaging). Thirty patients with sciatica severe enough to require a discectomy and 46 asymptomatic volunteers (controls) were included in this study. Both groups had a clinical examination as well as a magnetic resonance investigation of the lumbar spine. The longitudinal and transverse magnetic relaxation times (T1 and T2, respectively) were calculated from a set of 20 images obtained with five single-slice/multi-echo sequences at different repetition time values on a commercial whole-body system (1.5 T). Twenty-two symptomatic and asymptomatic disc herniations could be matched according to age, gender, disc level, and the extent of herniation (protrusion or extrusion) and were compared with regard to T1 and T2 relaxation times. Symptomatic disc herniations exhibited significantly (pT1 < 0.04 and pT2 < 0.003) shorter T1 (delta T1: -182.1 milliseconds, -15%) and T2 (delta T2: -11.0 milliseconds, -21%) relaxation times than matched asymptomatic herniations. Symptomatic disc herniations also exhibited more advanced disc degeneration as graded by Pearce's criteria (p < 0.01). These results suggest that symptomatic and morphologically matched asymptomatic disc herniations differ with regard to disc matrix composition.

Magnetic resonance imaging and spectroscopy of the intervertebral disc

“…7) (R ¼ À0.51, p < 0.001) (34). From these data, it can be seen that compared with T 2 values in normal discs of $65 ms (29), T 1r at 1.5 T is longer than 100 ms (34). There are no data on field strength dependence and frequency dispersion for T 1r in intervertebral disc in the literature, but this work is clearly warranted.…”

MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis

“…Disc protrusions are not uncommon in asymptomatic adult populations, with prevalences ranging from 10% to 30%, depending on the studied age group. [12][13][14][15][16][17][18][19][20] In general, epidemiologic studies demonstrate that the prevalence of disc protrusions in asymptomatic populations increases with age. [12][13][14][15][16][17][18][19][20] Our study found that nearly 20% of asymptomatic patients 50 years of age or younger had disc protrusion compared with nearly 40% in the symptomatic group.…”

T2 Relaxation Times Correlated with Stage of Lumbar Intervertebral Disk Degeneration and Patient Age

“…One report suggested that T2 relaxation times were lower in the lumbar disks that investigators determined were symptomatic disks than in the ones that they determined were not. 3 …”

“…T2 relaxation times have been used experimentally to measure disk aging and degeneration. [1][2][3][4] To validate its use, T2 relaxation times in cadaver disks have been correlated with the disk morphology or biochemistry. [5][6][7][8][9][10] The purpose of this study was to test the hypothesis that T2 relaxation time decreases as the stage of lumbar intervertebral disk degeneration advances.…”