title: Evaluation of the disco-vertebral junction using ultrashort time-to-echo magnetic resonance imaging: inter-reader agreement and association with vertebral endplate lesions.
abstract: OBJECTIVE
  To evaluate ultrashort time to echo (UTE) magnetic resonance (MR) morphology of the cartilaginous endplates (CEP) in cadaveric lumbar spines with bony vertebral endplate (VEP) lesions, to determine inter-reader agreement as well as associations between the CEP morphology and VEP lesions as well as other abnormalities.
  
  
  METHODS
  MR imaging of cadaveric lumbar spines from 10 donors was performed at 3T using a UTE MR sequence. Two musculoskeletal radiologists identified the location of vertebral endplate lesions in consensus. The morphology of the CEP overlying the lesions and in the adjacent normal regions was assessed individually. A total of 55 vertebral lesions and 55 normal regions were assessed. The presence of osteophytosis, morphological changes of the anterior and posterior longitudinal ligament, and intervertebral disc signal and morphology was also assessed. Agreement between observers was determined using Cohen's kappa analysis, and association between CEP and vertebral endplate lesions was determined using the chi square test.
  
  
  RESULTS
  Fifty-five vertebral endplate lesions were identified and the morphology of CEP evaluated by two readers was in substantial agreement with Cohen's kappa of 0.78. The presence of vertebral endplate abnormality was associated with the presence of osteophytes (39 out of 55 levels), altered morphology and signal of the anterior longitudinal ligament (23 out of 55 levels) and intervertebral discs (30 out of 55 levels).
  
  
  CONCLUSIONS
  UTE MRI enables evaluation of the CEP with substantial inter-reader agreement. Abnormal changes of the CEP may facilitate formation of lesions of vertebral endplate over time and are associated with degenerative changes of the lumbar spine.
authors.affiliation: Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Chen
authors.affiliation: Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.|Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, San Diego, CA, 92093-0997, USA.
authors.forename: Betty
authors.initials: B
authors.lastname: Tran
authors.affiliation: Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.|Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, San Diego, CA, 92093-0997, USA.
authors.forename: Reni
authors.initials: R
authors.lastname: Biswas
authors.affiliation: Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.|Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, San Diego, CA, 92093-0997, USA.
authors.forename: Sheronda
authors.initials: S
authors.lastname: Statum
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Diego, 9500 Gilman Drive, MC 0863, San Diego, CA, 92093-0863, USA.
authors.forename: Koichi
authors.initials: K
authors.lastname: Masuda
authors.affiliation: Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.|Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, San Diego, CA, 92093-0997, USA.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Chung
authors.affiliation: Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA. wbae@ucsd.edu.|Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, San Diego, CA, 92093-0997, USA. wbae@ucsd.edu.
authors.forename: Won C
authors.initials: WC
authors.lastname: Bae
mesh_terms: D002102:Cadaver; D002356:Cartilage / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging*; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D013382:Subtraction Technique
keywords: Back pain; Disc degeneration; Lumbar spine; Osteophyte; Schmorl’s node