Parametric T2 and T2* mapping techniques to visualize intervertebral disc degeneration in patients with low back pain: initial results on the clinical use of 3.0 Tesla MRI.
OBJECTIVE
To assess, compare and correlate quantitative T2 and T2* relaxation time measurements of intervertebral discs (IVDs) in patients suffering from low back pain, with respect to the IVD degeneration as assessed by the morphological Pfirrmann Score. Special focus was on the spatial variation of T2 and T2* between the annulus fibrosus (AF) and the nucleus pulposus (NP).


METHODS
Thirty patients (mean age: 38.1 ± 9.1 years; 20 female, 10 male) suffering from low back pain were included. Morphological (sagittal T1-FSE, sagittal and axial T2-FSE) and biochemical (sagittal T2- and T2* mapping) MRI was performed at 3 Tesla covering IVDs L1-L2 to L5-S1. All IVDs were morphologically classified using the Pfirrmann score. Region-of-interest (ROI) analysis was performed on midsagittal T2 and T2* maps at five ROIs from anterior to posterior to obtain information on spatial variation between the AF and the NP. Statistical analysis-of-variance and Pearson correlation was performed.


RESULTS
The spatial variation as an increase in T2 and T2* values from the AF to the NP was highest at Pfirmann grade I and declined at higher Pfirmann grades II-IV (p < 0.05). With increased IVD degeneration, T2 and T2* revealed a clear differences in the NP, whereas T2* was additionally able to depict changes in the posterior AF. Correlation between T2 and T2* showed a medium Pearson's correlation (0.210 to 0.356 [p < 0.001]).


CONCLUSIONS
The clear differentiation of IVD degeneration and the possible quantification by means of T2 and fast T2* mapping may provide a new tool for follow-up therapy protocols in patients with low back pain.
Welsch
Goetz Hannes
GH
MR Center-High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria.
Trattnig
Siegfried
S
Paternostro-Sluga
Tatjana
T
Bohndorf
Klaus
K
Goed
Sabine
S
Stelzeneder
David
D
Mamisch
Tallal Charles
TC
D000328:Adult; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications* / Q000175:diagnosis*; D017116:Low Back Pain / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged