title: Value of delayed gadolinium-enhanced magnetic resonance imaging of cartilage for the pre-operative assessment of cervical intervertebral discs.
abstract: The study was performed to preoperatively assess the cartilage integrity of cervical intervertebral discs (IVDs) using Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC). Therefore, 53 cervical intervertebral discs of nine preoperative patients with neck and shoulder/arm pain scheduled for discectomy (five females, four males; mean age: 47.1 ± 8.4 years; range: 36-58 years) were included for biochemical analysis in this retrospective study. The patients underwent 3T magnetic resonance imaging (MRI) including biochemical imaging with dGEMRIC and morphological, sagittal T2 weighted (T2w) imaging. Cervical IVDs were rated using an MRI based grading system for cervical IVDs on T2w images. Region-of-interest measurements were performed in the nucleus pulposus (NP) and annulus fibrosus (AF) and a dGEMRIC index was calculated. Our results demonstrated that IVDs scheduled for discectomy showed significantly lower dGEMRIC index compared to IVDs that did not require surgical intervention in NP and AF (NP: 898.4 ± 191.9 ms vs. 1,150.3 ± 320.7 ms, p = 0.008; AF: 738.7 ± 183.8 ms vs. 984.6 ± 178.9 ms, p = 0.008). For Miyazaki score 3, the dGEMRIC indices were significantly lower in IVDs scheduled for surgery compared to non-operated discs for NP (p = 0.043) and AF (p = 0.018). In conclusion we could demonstrate that biochemical imaging with dGEMRIC is feasible in cervical IVDs. Significantly lower dGEMRIC index suggested GAG depletion in degenerated cervical IVD, scheduled for discectomy. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1824-1830, 2017.
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schleich
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Miese
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Müller-Lutz
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Boos
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany.
authors.forename: Joel
authors.initials: J
authors.lastname: Aissa
authors.affiliation: Neurosurgical Department, University Hospital, Dusseldorf, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Nasca
authors.affiliation: Medical Faculty, Department of Orthopedics, University of Frankfurt/Main, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Zaucke
authors.affiliation: Neurosurgical Department, University Hospital, Dusseldorf, Germany.
authors.forename: Tamara
authors.initials: T
authors.lastname: Bostelmann
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Schimmöller
authors.affiliation: Medical Faculty, Department of Orthopedics, University Duesseldorf, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Bittersohl
authors.affiliation: Neurosurgical Department, University Hospital, Dusseldorf, Germany.
authors.forename: Hans-Jakob
authors.initials: HJ
authors.lastname: Steiger
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.affiliation: Neurosurgical Department, University Hospital, Dusseldorf, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Bostelmann
mesh_terms: D000328:Adult; D002358:Cartilage, Articular / Q000000981:diagnostic imaging*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D005260:Female; D005682:Gadolinium; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011509:Proteoglycans / Q000032:analysis*; D012189:Retrospective Studies
chemical_list: D011509:Proteoglycans; D005682:Gadolinium
keywords: MRI; biochemical imaging; cartilage imaging; dGEMRIC; spine