Abstract
BackgroundThe treatment planning of spine pathologies requires information on the rigidity and permeability of the intervertebral discs (IVDs). Magnetic resonance imaging (MRI) offers great potential as a sensitive and non-invasive technique for describing the mechanical properties of IVDs. However, the literature reported small correlation coefficients between mechanical properties and MRI parameters. Our hypothesis is that the compressive modulus and the permeability of the IVD can be predicted by a linear combination of MRI parameters.MethodsSixty IVDs were harvested from bovine tails, and randomly separated in four groups (in-situ, digested-6h, digested-18h, digested-24h). Multi-parametric MRI acquisitions were used to quantify the relaxation times T1 and T2, the magnetization transfer ratio MTR, the apparent diffusion coefficient ADC and the fractional anisotropy FA. Unconfined compression, confined compression and direct permeability measurements were performed to quantify the compressive moduli and the hydraulic permeabilities. Differences between groups were evaluated from a one way ANOVA. Multi linear regressions were performed between dependent mechanical properties and independent MRI parameters to verify our hypothesis. A principal component analysis was used to convert the set of possibly correlated variables into a set of linearly uncorrelated variables. Agglomerative Hierarchical Clustering was performed on the 3 principal components.ResultsMultilinear regressions showed that 45 to 80% of the Young’s modulus E, the aggregate modulus in absence of deformation HA0, the radial permeability kr and the axial permeability in absence of deformation k0 can be explained by the MRI parameters within both the nucleus pulposus and the annulus pulposus. The principal component analysis reduced our variables to two principal components with a cumulative variability of 52-65%, which increased to 70-82% when considering the third principal component. The dendograms showed a natural division into four clusters for the nucleus pulposus and into three or four clusters for the annulus fibrosus.ConclusionsThe compressive moduli and the permeabilities of isolated IVDs can be assessed mostly by MT and diffusion sequences. However, the relationships have to be improved with the inclusion of MRI parameters more sensitive to IVD degeneration. Before the use of this technique to quantify the mechanical properties of IVDs in vivo on patients suffering from various diseases, the relationships have to be defined for each degeneration state of the tissue that mimics the pathology. Our MRI protocol associated to principal component analysis and agglomerative hierarchical clustering are promising tools to classify the degenerated intervertebral discs and further find biomarkers and predictive factors of the evolution of the pathologies.
Highlights
The treatment planning of spine pathologies requires information on the rigidity and permeability of the intervertebral discs (IVDs)
The enzyme treatment induced mechanical changes in both the annulus fibrosus and nucleus pulposus, with a decrease of the compressive moduli and an increase of the permeabilities (Table 2). For both the annulus fibrosus and nucleus pulposus, apparent diffusion coefficient (ADC) decreased while FA increased between in-situ and digested groups while there were no changes on T1, T2, and Magnetization transfer (MT) (Table 3)
This study showed that the compressive modulus and the permeability of isolated IVDs can be assessed mostly by magnetization transfer sequences and diffusion tensor imaging
Summary
The treatment planning of spine pathologies requires information on the rigidity and permeability of the intervertebral discs (IVDs). Reverse methods including a finite element model of the spine have been developed but the segmentation process of the radiographs and the inversion of the reverse problem are computationally challenging. These methods are not clinically used on a regular basis, and the information remains global. It is important to be able to quantify the compressive modulus of the IVD to assess the spine rigidity. The IVD is an avascular tissue, except in the outermost annulus fibrosus, and its nutrition is achieved by diffusion from the vertebral endplates [12]. We only know the changes in the zero-strain permeability from the nucleus pulposus (0.68±0.09* 10-15m4N-1s-1) to the annulus fibrosus (0.24±0.19*10-15 m4N-1s-1) as computed from confined compression tests and non linear biphasic models, with no differentiation between inner and outer annulus fibrosus [10,13]
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