The comparative study of radiograph, MRI and pathology in degeneration of lumbar intervertebral disc / 中华放射学杂志

ABSTRACT

Objective To investigate the pathology and MRI features of the degeneration of lumbar intervertebral discs (IVD). Methods Thirteen human lumbar spine segments with 31 IVDs were harvested from fresh cadavers. High quality radiographs were taken for all specimens. Five segments with 20 IVD underwent MRI. Then, the radiographic and MRI findings were correlated with corresponding 87 pathologic sections. Results Variant degeneration was observed in pathologic sections in all 31 IVDs. With MRI T 2WI images, 20 IVDs showed linear and spotty high signal in the annular fibers, or most of the IVD showed high signal. On pathologic cuts, 22 of 31 IVDs showed infolding of annular fibers, 18 of 31 showed outfolding of annular fibers. On MRI T 1WI and T 2WI images, infolding and outfinding of annular fibers were seen as low signal. 20 of 31 IVDs had necrotic debris of cells in the nucleus pulposus. 14 of 20 demonstrated spotty low signal areas on MRI T 2WI images.7 Schmorl nodules were found. On pathologic sections Schmorl nodules were seen as IVD tissue protruding into vertebral endplates, they were seen as high signal on T 2WI images. Two large fissures found on sections were seen as low signal on T 2WI. Degenerative fibrosis seen on 6 IVD, which showed intermediate signal on T 2WI images. However, radiographs only demonstrated osteophytes on 3 vertebrae, 7 Schmorl's nodules. Sclerotic, concave and irregular endplates were seen in 11 IVDs, the latter is the indication of cartilaginous endplate disruption. Conclusion MRI is very useful in demonstrating the degeneration of IVD, radiograph is able to indirectly show the disapperance of cartilaginous endplate.