Abstract
BackgroundMagnetic resonance imaging (MRI) is a useful non-invasive tool for evaluating abnormalities of intervertebral discs. However, there are few studies which applied functional MRI techniques to investigate degenerative changes in cervical and cervicothoracic junction (CTJ) spine among adults. The aim of this study was to compare T2 relaxation time measurement evaluation with morphological grading for assessing cervical and CTJ intervertebral discs (IVD) in the patients suffering neck, shoulder, and upper back pain.MethodsSixty-three patients (378 IVDs) and 60 asymptomatic volunteers (360 IVDs) of the cervical and CTJ discs were assessed using a 3.0 T magnetic resonance imaging (MRI) protocol, including an sagittal T2 relaxation time protocol. The relaxation time values of the nucleus pulposus (NP) were recorded and all discs were visually graded according to Pfirrman’s grading system. The correlation between T2 relaxation time values and qualitative clinical grading of degeneration, patient age, sex and anatomic level were analyzedResultsThere is a clear trend of decreasing mean T2 values of the NP associate with increasing Pfirrmann grades (C2-T1) for both patients and asymptotic volunteers. Significant T2 differences were seen among grades I-V (P < 0.05). However, grade V was not observed in the CTJ. Linear correlation analysis revealed a strong negative association between T2 values of the NP and Pfirrmann grade (r = −0.588, r = −0.808) of C2-7 and C7T1. Age were also significantly correlated NP T2 values (r = −0.525, r = −0.723) for patients and volunteers. Moreover, the receiver operating characteristic analysis for average measures in a range from 0.70-0.79 (C2-7) to 0.84-0.89 (C7T1) for patients.ConclusionsT2 quantitation provides a more sensitive and robust approach for detecting and characterizing the early stage of IVD degeneration and age-associated disc changes.
Highlights
Magnetic resonance imaging (MRI) is a useful non-invasive tool for evaluating abnormalities of intervertebral discs
NP, nucleus pulposus. @ Compared with T2 values of NP of grade I for C2-7, P < 0.000; #Compared with T2 values of NP of grade II for C2-7, P < 0.000; ^Compared with T2 values of NP of grade III for C2-7, P < 0.002; &Compared with T2 values of NP of grade V for C2-7, P < 0.05; $ Compared with T2 values of NP of grade I for C7T1, P < 0.004; %Compared with T2 values of NP of grade II for C7T1, P < 0.000; ~Compared with T2 values of NP of grade III for C7T1, P < 0.05
Regarding the T2 values of NP, significance was detected between T2 values of asymptomatic volunteers in the different Pfirrmann grades (Table 2)
Summary
Magnetic resonance imaging (MRI) is a useful non-invasive tool for evaluating abnormalities of intervertebral discs. There are few studies which applied functional MRI techniques to investigate degenerative changes in cervical and cervicothoracic junction (CTJ) spine among adults. The aim of this study was to compare T2 relaxation time measurement evaluation with morphological grading for assessing cervical and CTJ intervertebral discs (IVD) in the patients suffering neck, shoulder, and upper back pain. Cervical intervertebral disc (IVD) degeneration changes range from 5% to 10% in people between the ages of 20 and 30 years, to more than 50% by 45 years of age. Magnetic resonance imaging (MRI) is a promising non-invasive examining tool for evaluating abnormalities of IVD. A reliable quantification characterized by loss of water or PG in an intact disc is not provided in such system to evaluate the degenerative degree in early intervertebral disc degeneration (IVDD) stages
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