title: Ultrashort time-to-echo MRI of the cartilaginous endplate: technique and association with intervertebral disc degeneration.
abstract: BACKGROUND
  The purpose of this study was to report the feasibility of the ultrashort time-to-echo (UTE) MRI technique to assess cartilaginous endplate (CEP) defects in humans in vivo and to assess their relationship with intervertebral disc (IVD) degeneration.
  
  
  METHODS
  Nine volunteer subjects (mean age = 43.9 years; range = 22-61 years) were recruited, representing 54 IVDs and 108 CEPs. The subjects underwent T2-weighted and UTE MRI to assess for the presence and severity of IVD degeneration, and for the presence of CEP defects, respectively, from T12 to S1. IVD degeneration was graded according to the Schneiderman et al. classification on T2-weighted MRI. CEP defects were defined on UTE MRI as discontinuity of high signal over four consecutive images and were independently assessed by two observers.
  
  
  RESULTS
  Thirty-seven out of 108 (34.3%) CEPs had defects, which mainly occurred at T12/L1, L1/L2 and L4/L5 (P = 0.008). Multivariate logistic regression revealed that lower body mass index (P = 0.009) and younger (P = 0.034) individuals had a decreased likelihood of having CEP defects. A statistically significant association was found to exist between the presence of CEP defects and IVD degeneration (P = 0.036). A higher prevalence of degenerated IVDs with CEP defects was found at L4/5 and L5/S1, while degenerated IVDs with no CEP defects were found throughout the whole lumbar region. Mean IVD degeneration scores of the L4/5 and L5/S1 levels with CEP defects were higher in comparison with those with no CEP defects.
  
  
  CONCLUSIONS
  Our study demonstrates the feasibility of using UTE MRI in humans in vivo to assess the integrity of the CEP. A statistically significant association was found to exist between the presence of CEP defects and IVD degeneration. In the lower lumbar region, more severe degeneration was found to occur in the IVDs with CEP defects than in those without defects.
authors.affiliation: Department of Diagnostic Radiology, University of Hong Kong, Pokfulam.
authors.forename: Travis
authors.initials: T
authors.lastname: Law
authors.forename: Marina-Portia
authors.initials: MP
authors.lastname: Anthony
authors.forename: Queenie
authors.initials: Q
authors.lastname: Chan
authors.forename: Dino
authors.initials: D
authors.lastname: Samartzis
authors.forename: Mina
authors.initials: M
authors.lastname: Kim
authors.forename: Kenneth M C
authors.initials: KM
authors.lastname: Cheung
authors.forename: Pek-Lan
authors.initials: PL
authors.lastname: Khong
mesh_terms: D000328:Adult; D002358:Cartilage, Articular / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007403:Intervertebral Disc / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: UTE; disc degeneration; endplate defect; lumbar; magnetic resonance imaging; ultrashort time-to-echo