A comparative study of diffusion kurtosis imaging and T2* mapping in quantitative detection of lumbar intervertebral disk degeneration.

Abstract

To assess the feasibility of diffusion kurtosis imaging (DKI) for diagnosing lumbar intervertebral disk degeneration (IDD) and to compare the potential of DKI and T2* mapping in the diagnosis of early IDD. Sagittal T2WI, DKI, and T2* mapping were performed in 75 subjects with 375 lumbar intervertebral disks at a 3.0-T MRI. DKI-related parameters including mean kurtosis (MK), mean diffusivity (MD), fractional anisotropy (FA), and T2* values were calculated for each disk which was segmented into three regions: nucleus pulposus (NP), anterior annulus fibrosus (AAF), and posterior annulus fibrosus (PAF). MK and FA were positively correlated with Pfirrmann grade (all P < 0.001). MD and T2* were negatively correlated with Pfirrmann grade (all P < 0.001) except for T2* value of AAF (r = 0.087, P > 0.05). MK and FA values increased, while MD and T2* values decreased with age. No statistical significance was found between men and women (P > 0.05). Cephalic lumbar disks (L1/L2 and L2/L3) got lower MK and FA values than caudal lumbar disks (L4/L5 and L5/S1) (all P < 0.05), while cephalic lumbar disks got higher MD value than caudal lumbar disks (all P < 0.05). ROC analysis demonstrated that MK, MD, and FA showed significantly higher diagnostic accuracies than T2*, especially in NP and PAF. DKI can be used to assess human lumbar IDD. And DKI was more sensitive to the quantitative detection of early lumbar IDD than T2* mapping. These slides can be retrieved under Electronic Supplementary Material.