Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, San Francisco, California, USA.
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, USA.
J Magn Reson Imaging. 2019 Oct;50(4):1219-1226. doi: 10.1002/jmri.26675. Epub 2019 Jan 30.
There is an interplay between the intervertebral disc (IVD) and the adjacent bone marrow that may play a role in the development of IVD degeneration and might influence chronic lower back pain (CLBP).
To apply novel quantitative MRI techniques to assess the relationship between vertebral bone marrow fat (BMF) and biochemical changes in the adjacent IVD.
Prospective.
Forty-six subjects (26 female and 20 male) with a mean age of 47.3 ± 12.0 years.
FIELD STRENGTH/SEQUENCE: 3 T MRI; a combined T and T mapping pulse sequence and a 3D spoiled gradient recalled sequence with six echoes and iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) reconstruction algorithm.
Using quantitative MRI, the vertebral BMF fraction was measured as well as the biochemical composition (proteoglycan and collagen content) of the IVD. Furthermore, clinical Pfirrmann grading, Oswestry disability index (ODI), and visual analog scale (VAS) was assessed.
Mixed random effects models accounting for multiple measurements per subject were used to assess the relationships between disc measurements and BMF.
The relationships between BMF (mean) and T /T (mean and SD) were significant, with P < 0.05. Significant associations (P < 0.001) were found between clinical scores (Pfirrmann, ODI, and VAS) with T /T (mean and SD). BMF mean was significantly related to ODI (P = 0.037) and VAS (P = 0.043), but not with Pfirrmann (P = 0.451). In contrast, BMF SD was significantly related to Pfirrmann (P = 0.000) but not to ODI (P = 0.064) and VAS (P = 0.13).
Our study demonstrates significant associations between BMF and biochemical changes in the adjacent IVD, both assessed by quantitative MRI; this may suggest that the conversion of hematopoietic bone marrow to fatty bone marrow impairs the supply of available nutrients to cells in the IVD and may thereby accelerate disc degeneration.
2 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:1219-1226.
椎间盘（IVD）与相邻骨髓之间存在相互作用，这种相互作用可能在 IVD 退变的发展中起作用，并可能影响慢性下腰痛（CLBP）。
应用新型定量 MRI 技术评估椎骨骨髓脂肪（BMF）与相邻 IVD 生化变化之间的关系。
前瞻性。
46 名受试者（26 名女性和 20 名男性），平均年龄为 47.3±12.0 岁。
磁场强度/序列：3T MRI；T 和 T 映射脉冲序列以及具有六个回波和迭代分解水和脂肪的 3D 扰相梯度回波序列与不对称回波和最小二乘估计（IDEAL）重建算法。
使用定量 MRI 测量椎骨 BMF 分数以及 IVD 的生化组成（蛋白聚糖和胶原蛋白含量）。此外，还评估了 Pfirrmann 临床分级、Oswestry 残疾指数（ODI）和视觉模拟量表（VAS）。
使用混合随机效应模型，考虑每个受试者的多次测量，评估椎间盘测量值与 BMF 之间的关系。
BMF（平均值）与 T/T（平均值和标准差）之间存在显著相关性，P<0.05。临床评分（Pfirrmann、ODI 和 VAS）与 T/T（平均值和标准差）之间存在显著关联（P<0.001）。BMF 平均值与 ODI（P=0.037）和 VAS（P=0.043）显著相关，但与 Pfirrmann 无关（P=0.451）。相反，BMF 标准差与 Pfirrmann 显著相关（P=0.000），但与 ODI（P=0.064）和 VAS（P=0.13）无关。
我们的研究表明，定量 MRI 评估的 BMF 与相邻 IVD 的生化变化之间存在显著相关性，这可能表明造血骨髓向脂肪骨髓的转化会损害 IVD 细胞的营养供应，从而加速椎间盘退变。
2 技术功效阶段：3 J. Magn. Reson. Imaging 2019;50:1219-1226.
