title: Association between intervertebral disc degeneration and endplate perfusion studied by DCE-MRI.
abstract: OBJECTIVE
  The goal of this study was to study the association between solute transport mechanisms in cartilaginous disc endplates and the degeneration of intervertebral discs. Intervertebral disc degeneration is a multi-factorial process. It is suspected that poor nutrient delivery to discs might be a factor leading to degeneration. Several studies suggest that defects in disc endplates could lead to poor transport of nutrients. An imaging technique assessing endplate perfusion could be a valuable tool in investigating disc degeneration. There is currently no universally accepted technique assessing endplate perfusion in vivo.
  
  
  METHODS
  Nine adult patients exhibiting varying levels of intervertebral disc degeneration were included. MRI was used to study the association between blood perfusion in 90 lumbar disc endplates and disc degeneration in 45 lumbar discs. Solute transport mechanism through endplates was assessed indirectly by dynamic contrast enhanced (DCE) MRI. T2-weighted MRI was used for conventional Pfirrmann classification.
  
  
  RESULTS
  A positive association was observed between Pfirrmann grades and endplate DCE-MRI enhancement. A differential enhancement between cranial and caudal endplates was also observed, which increased with Pfirrmann grades. This differential enhancement was also dependent on the lumbar level.
  
  
  CONCLUSIONS
  Increased MRI signal enhancement in the cartilaginous endplates of degenerated discs might indicate damage to the subchondral bone of the vertebral bodies. The endplate enhancement characteristic could aid in understanding the pathophysiology of disc degeneration and planning treatment more effectively.
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Froedtert Hospital, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA, lmuftuler@mcw.edu.
authors.forename: L Tugan
authors.initials: LT
authors.lastname: Muftuler
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Jarman
authors.forename: Hon J
authors.initials: HJ
authors.lastname: Yu
authors.forename: Vance O
authors.initials: VO
authors.lastname: Gardner
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Maiman
authors.forename: Volkan Emre
authors.initials: VE
authors.lastname: Arpinar
mesh_terms: D000328:Adult; D001692:Biological Transport; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007403:Intervertebral Disc / Q000098:blood supply* / Q000378:metabolism; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000098:blood supply / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA