title: Pedicle marrow signal hyperintensity on short tau inversion recovery- and t2-weighted images: prevalence and relationship to clinical symptoms.
abstract: OBJECTIVE
  Lumbar pedicle marrow hyperintense signal on T2- and STIR-weighted images is not an uncommon finding. We hypothesize that these marrow signal intensity changes and their behavior within the pedicle are associated with clinical symptoms and that their improvement or resolution correlates with clinical improvement. We investigated the prevalence of these pedicle marrow changes, associated morphologic abnormalities, and the relationship to symptoms over time.
  
  
  METHODS
  Prevalence was evaluated prospectively in 246 patients and retrospectively in 400 patients. To analyze the relationship between changes in signal intensity over time and symptoms, a third group of 30 patients was followed clinically for assessment of pain and functional limitation and with MR studies for 18 months or until signal intensity changes resolved.
  
  
  RESULTS
  The prevalence of pedicle marrow hyperintensity on T2 and STIR-weighted sequences was 1.7%. Associated morphologic abnormalities were pars interarticularis and pedicle fractures and degenerative facets. In the longitudinal study, pedicle marrow signal hyperintensity on T2- and STIR-weighted images resolved in 17 patients and persisted in 5 patients. The extent, intensity, and resolution of signal intensity changes significantly related to the degree of functional limitation (P = .01).
  
  
  CONCLUSIONS
  Resolution of pedicle marrow hyperintensity on T2 and STIR-weighted images was associated with improved functional testing and a trend toward decreased pain.
authors.affiliation: Imaging, Institutes, and Quantitative Health Sciences (N.O.), Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: B
authors.initials: B
authors.lastname: Borg
authors.forename: M T
authors.initials: MT
authors.lastname: Modic
authors.forename: N
authors.initials: N
authors.lastname: Obuchowski
authors.forename: G
authors.initials: G
authors.lastname: Cheah
mesh_terms: D000293:Adolescent; D000328:Adult; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000453:epidemiology* / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D013169:Spondylolysis / Q000453:epidemiology* / Q000473:pathology*; D021801:Zygapophyseal Joint / Q000473:pathology