ABSTRACT
Objective: To quantitatively evaluate the changes of diffusional and perfusion of degenerative water molecules in lumbar inervertebral disc by multiple b-value voxel incoherent motion imaging. Methods: We selected 60 patients (34 males and 26 females) with low back pain or sciatica from The First Affiliated Hospital of Xi'an Jiaotong University. The subjects underwent lumbar MRI sagittal T2WI and median sagittal multiple b-value weighted imaging. We graded the L1-S1 disc according to the Pfirrmann grading standards, and measured the ADCslow, ADCfast, f values of the nucleus pulla, and the anterior and posterior edges of the annulus fibrosus. We compared the mean values of ADCslow, ADCfast, f at the anterior and posterior edges of nucleus pulposus and annulus fibrosus and analyzed the correlation analysis between them and the grade of degeneration. Single factor analysis of variance combined with SNK test was used in the statistics. Results: A total of 300 discs were measured and the statistical results showed that: ① The mean value of the ADC of the nucleus pulposus of each grade of the lumbar disc decreased with the increase of the grade. Although there was no significant difference between grade and grade Ⅱ, grade and grade , there were statistically significant differences between the other grades (P0.05). Conclusion: The quantitative measurement of nucleus pulposus ADCslow based on IVIM is a potential and more sensitive quantitative magnetic resonance method for evaluating early degeneration of lumbar disc.
ABSTRACT
Objective To determine the correlation between the Modic degeneration of lumbar endplate on MRI and the pain provocation or degeneration of lumbar intervertebral discs observed on CT discography. Methods One hundred and twenty lumbar intervertebral discs (40 L3-4, 40 L4-5, 40 L5S1 intervertebral discs) of 40 patients among 45 patients were examined. 120 intervertebral discs underwent discography guided by CT scan, according to Dallas Discography Description system, degeneration of lumbar intervertebral disc were divided into 0-3 grade, and pain provocation were graded into negative, indifferent and positive. On the basis of Modic classification system of the lumbar endplate changes and Pearce classification system of the degeneration of lumbar intervertebral disc, the lumbar endplate changes were divided into 0-3 grade, the degeneration of lumbar intervertebral disc were graded into Ⅰ-Ⅴ. All the results were analysed by Chi-Square test for the correlations. Results There was positive correlation between pain provocation test and the lumbar endplate Modic degeneration; There was a positive correlation between the Modic degeneration of lumbar endplate and the degeneration of lumbar intervertebral disc and so is the relation between the CT discography and MRI on discs. Conclusion There is positive correlation between pain provocation test and the Modic degeneration of lumbar endplate, it suggest the endplate might be one of the sources of low back pain. There is a positive correlation between the Modic degeneration of lumbar endplate and the degeneration of lumbar intervertebral disc.