Zhang Yi, Hu Jianzhong, Duan Chunyue, Hu Ping, Lu Hongbin, Peng Xianjing
Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
PLoS One. 2017 Jun 1;12(6):e0178406. doi: 10.1371/journal.pone.0178406. eCollection 2017.
Recent advancements in magnetic resonance imaging have allowed for the early detection of biochemical changes in intervertebral discs and articular cartilage. Here, we assessed the feasibility of axial T2, T2* and T1ρ mapping of the lumbar facet joints (LFJs) to determine correlations between cartilage and intervertebral discs (IVDs) in early lumbar vertebral degeneration. We recruited 22 volunteers and examined 202 LFJs and 101 IVDs with morphological (sagittal and axial FSE T2-weighted imaging) and axial biochemical (T2, T2* and T1ρ mapping) sequences using a 3.0T MRI scanner. IVDs were graded using the Pfirrmann system. Mapping values of LFJs were recorded according to the degeneration grades of IVDs at the same level. The feasibility of T2, T2* and T1ρ in IVDs and LFJs were analyzed by comparing these mapping values across subjects with different rates of degeneration using Kruskal-Wallis tests. A Pearson's correlation analysis was used to compare T2, T2* and T1ρ values of discs and LFJs. We found excellent reproducibility in the T2, T2* and T1ρ values for the nucleus pulposus (NP), anterior and posterior annulus fibrosus (PAF), and LFJ cartilage (intraclass correlation coefficients 0.806-0.955). T2, T2* and T1ρ mapping (all P<0.01) had good Pfirrmann grade performances in the NP with IVD degeneration. LFJ T2* values were significantly different between grades I and IV (PL = 0.032, PR = 0.026), as were T1ρ values between grades II and III (PL = 0.002, PR = 0.006) and grades III and IV (PL = 0.006, PR = 0.001). Correlations were moderately negative for T1ρ values between LFJ cartilage and NP (rL = -0.574, rR = -0.551), and between LFJ cartilage and PAF (rL = -0.551, rR = -0.499). T1ρ values of LFJ cartilage was weakly correlated with T2 (r = 0.007) and T2* (r = -0.158) values. Overall, we show that axial T1ρ effectively assesses early LFJ cartilage degeneration. Using T1ρ analysis, we propose a link between LFJ degeneration and IVD NP or PAF changes.
磁共振成像技术的最新进展使得能够早期检测椎间盘和关节软骨的生化变化。在此,我们评估了腰椎小关节(LFJs)轴向T2、T2和T1ρ成像的可行性,以确定早期腰椎退变中软骨与椎间盘(IVDs)之间的相关性。我们招募了22名志愿者,使用3.0T MRI扫描仪,通过形态学序列(矢状位和轴向FSE T2加权成像)和轴向生化序列(T2、T2和T1ρ成像)对202个LFJs和101个IVDs进行了检查。IVDs采用Pfirrmann系统分级。根据同一水平IVDs的退变等级记录LFJs的成像值。使用Kruskal-Wallis检验比较不同退变率受试者的这些成像值,分析T2、T2和T1ρ在IVDs和LFJs中的可行性。采用Pearson相关分析比较椎间盘和LFJs的T2、T2和T1ρ值。我们发现,对于髓核(NP)、前、后纤维环(PAF)和LFJ软骨,T2、T2和T1ρ值具有出色的可重复性(组内相关系数为0.806 - 0.955)。随着IVD退变,T2、T2和T1ρ成像(所有P<0.01)在NP中具有良好的Pfirrmann分级表现。I级和IV级之间的LFJ T2值有显著差异(PL = 0.032,PR = 0.026),II级和III级之间以及III级和IV级之间的T1ρ值也有显著差异(PL = 0.002,PR = 0.006;PL = 0.006,PR = 0.001)。LFJ软骨与NP之间(rL = -0.574,rR = -0.551)以及LFJ软骨与PAF之间(rL = -0.551,rR = -0.499)的T1ρ值呈中度负相关。LFJ软骨的T1ρ值与T2(r = 0.007)和T2(r = -0.158)值呈弱相关。总体而言,我们表明轴向T1ρ能有效评估早期LFJ软骨退变。通过T1ρ分析,我们提出了LFJ退变与IVD的NP或PAF变化之间的联系。