Abstract
BackgroundAxial loading during MRI (alMRI) combined with T2 mapping recently was shown as a promising method to reveal biomechanical intervertebral disc (IVD) characteristics. This feasibility study aims to investigate whether there is a diurnal variation in the IVD T2-value when using alMRI. This is of importance for the planning of when to perform alMRI investigations and for interpretations of alMRI findings in relation to clinical symptoms.MethodsSix healthy volunteers (30 lumbar discs), were examined with alMRI at three different sessions during 1 day. To be representative for a low back pain cohort in terms of age and IVD degeneration the included participants had a wide age range (27-63y) and all Pfirrmann grades represented. The T2-values were measured in five IVD regions of interest (ROI). The ROIs were equally large in sagittal plane with ROI1 representing anterior parts of the IVD, ROI5 posterior IVD parts and ROI2–4 the parts in between.ResultsT2-values of the entire IVD varied between 38 and 138 ms at 7 am, 33-143 ms at 11.30 am, and 31-147 ms at 4 pm with large regional IVD variations at all time points. No significant alterations of the T2-values over the day were found, neither for the entire IVD (p = 0.4) nor for the various ROIs (p = 0.2–1.0). Neither when correlated to Pfirrmann grade, any significant diurnal T2-value changes were found.ConclusionsWith alMRI, only minor diurnal T2-value changes were found in the lumbar discs. Nonsignificant and neglectable diurnal changes are advantageous both for research purposes, as well as in the clinical setting, giving comparable and robust data regardless of at what time-point the alMRI is performed.
Highlights
Axial loading during magnetic resonance imaging (MRI) combined with T2 mapping recently was shown as a promising method to reveal biomechanical intervertebral disc (IVD) characteristics
Results Axial loading during MRI (alMRI) T2-values over the day for the entire IVDs and sub-regions The alMRI T2-value slightly decreased over the day in ROI2 to ROI4, from 102 ms (ROI2), 128 ms (ROI3) and 118 ms (ROI4) in the morning to 94 ms, 121 ms and 111 ms, respectively in the afternoon (Fig. 2/Table 2)
UMRI T2-values over the day for the entire IVDs and sub-regions Neither for the entire IVDs nor for the separate subregions were any significant diurnal alterations found with uMRI
Summary
Axial loading during MRI (alMRI) combined with T2 mapping recently was shown as a promising method to reveal biomechanical intervertebral disc (IVD) characteristics. This feasibility study aims to investigate whether there is a diurnal variation in the IVD T2-value when using alMRI. In spite of extensive research, trying to establish diagnostic methods for detailed assessment of intervertebral disc (IVD) degeneration and spinal pain predictors, current imaging methods are insufficient. Combining quantitative magnetic resonance imaging (MRI) of the lumbar back with axial loading during MRI (alMRI), has been shown to be a promising way to improve the imaging diagnostics of degenerative disc disease, and reveal functional IVD characteristics [8].
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