Abstract
ObjectiveTo investigate the potential clinical application of quantitative MRI in assessing the correlation between lumbar vertebrae bone marrow fat deposition and intervertebral disc degeneration.Materials and methodsA total of 104 chronic lower-back pain volunteers underwent 3.0-T MRI with T2-weighted imaging, T2 mapping, and iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL-IQ) between August 2018 and June 2019. Each disc was assessed with T2 value by T2 mapping, and the L1-S1 vertebral bone marrow fat fraction was assessed by IDEAL-IQ. The differences and relationship between T2 value and the adjacent vertebral bone marrow fat fraction values within the five Pfirrmann groups, five age groups, and five lumbar levels were statistically analyzed.ResultsThe vertebral bone marrow fat fraction had a significant negative correlation with T2 values of nucleus pulposus’ T2 values (p < 0.001). However, the significant negative correlation was only found between T2 values of nucleus pulposus and adjacent vertebral bone marrow fat in Pfirrmann II–III, L1/2-L5/S1 level, and 40–49 years’ age groups. Pfirrmann grades of the intervertebral disc were positively correlated with adjacent vertebrae bone marrow fat fraction (p < 0.05).ConclusionLumbar bone marrow fat deposition significantly increases during the early stages of intervertebral disc degeneration. Quantitative measurements of bone marrow fat deposition and water content of intervertebral discs have a predictive value and are an important supplement to the qualitative traditional classification strategies for the early stages of intervertebral disc degeneration.
Highlights
Lumbar intervertebral disc degeneration (IVDD) is a common orthopedics’ disease that causes lower-back pain [1,2,3], with early biochemical changes which include proteoglycans and hydration loss, and late morphologic changes which include disc height loss, nucleus pulposus (NP) herniation, and annular tears [4]
We indicated the round region of interesting (ROI) within the anterior annulus fibrosus (AAF) to measure the T2 value and copied the ROI onto the nucleus pulposus (NP) and posterior annulus fibrosus (PAF) to measure the T2 values, respectively (Fig. 1)
We investigated whether IVDD is associated with adjacent vertebrae bone marrow fat (BMF) using advanced quantitative MRI techniques
Summary
Lumbar intervertebral disc degeneration (IVDD) is a common orthopedics’ disease that causes lower-back pain [1,2,3], with early biochemical changes which include proteoglycans and hydration loss, and late morphologic changes which include disc height loss, nucleus pulposus (NP) herniation, and annular tears [4]. The lumbar disc is the largest avascular tissue within the human body, nourished primarily by the diffusion of micro-vessels in the adjacent vertebral bodies through the cartilaginous endplate [5]. Interference with this pathway may be a risk factor for intervertebral disc (IVD) metabolism. Osteoporosis is closely associated with IVDD [8] while vertebral osteoporosis is associated with IVDD in postmenopausal women [9]. IVDD is often concomitant with osteoporosis [10, 11], suggesting that osteoporosis and IVDD development may be an accompanying process and may explain b
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