Department of Radiology, Tianjin Hospital, Tianjin, China.
Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Orthop Surg. 2020 Aug;12(4):1164-1172. doi: 10.1111/os.12727. Epub 2020 Jun 24.
The T2 value of lumbar cartilage endplates was measured using the T2 mapping imaging technique, aiming to explore the correlation between the T2 value and Pfirrmann grading of intervertebral discs.
A total of 130 patients with lumbar spine MR examination due to persistent low back pain were enrolled, including 71 men and 59 women (age: 21-63 years). Lumbar Modic changes and Schmorl nodules were recognized by conventional T1WI and T2WI images in 49 patients, and these patients were excluded from the study. A total of 81 patients were enrolled in this study, including 45 men (45.16 ± 12.20 years) and 36 women (43.33 ± 11.27 years). Pfirrmann (Pm) grading of each lumbar disc was performed based on conventional T2WI median sagittal images and the position of cartilage endplates (CEP) was determined by IDEAL-SPGR images. Meanwhile, the T2 mapping technique was used to obtain T2 values of cartilage endplates. The T2 values of CEP corresponding to different Pm grade discs were compared, and the correlation between the T2 value and the Pm grade of intervertebral discs was analyzed.
The T2 values of cephalic and caudal CEP of L in Pm grades I-II, Pm grades III, and Pm grades IV-V were 61.96 ± 5.89 ms, 54.45 ± 3.29 ms, 42.47 ± 3.69 ms and 64.35 ± 5.93 ms, 55.28 ± 3.97 ms, 44.75 ± 2.12 ms, respectively. For cephalic and caudal CEP of L , the T2 values in Pm grades I-II, Pm grades III, and Pm grades IV-V were 62.96 ± 6.93 ms, 55.19 ± 4.02 ms, 48.67 ± 4.56 ms and 65.51 ± 6.49 ms, 57.16 ± 5.55 ms, 52.05 ± 4.20 ms, respectively. The T2 values of cephalic and caudal CEP from L to L -S in Pm grades I-II, Pm grades III, and Pm grades IV-V were (63.72 ± 5.76 ms, 53.96 ± 6.52 ms, 48.05 ± 5.00 ms), (65.46 ± 6.37 ms, 55.70 ± 7.50 ms, 48.10 ± 3.27 ms); (66.34 ± 7.68 ms, 56.76 ± 9.48 ms, 47.80 ± 4.33 ms), (64.44 ± 4.65 ms, 59.30 ± 8.80 ms, 47.30 ± 5.78 ms), (65.32 ± 5.11 ms, 55.33 ± 6.65 ms, 48.18 ± 5.37 ms), and (63.47 ± 4.92 ms, 50.32 ± 8.86 ms, 44.77 ± 4.69 ms), respectively. There were significant differences in T2 values of cartilage endplates between the Pm grades I-II, III, and IV-V of intervertebral discs (P = 0.000). T2 values corresponding to Pm I-II grades were higher than those in Pm III grade, while T2 values in Pm grades IV-V were lowest. The T2 value of the L , L -S segment endplates was highly correlated with the Pm grades (r = -0.711, -0.721, -0.796, -0.745; P = 0.000) and that of L , L endplates were moderately correlated (r = -0.542, -0.562, -0.637, -0.612; P = 0.000).
The T2 values of cartilage endplates revealed varying degrees of degeneration of intervertebral discs, and more severe degeneration corresponded to lower T2 values. Measurement of changes in the T2 value through cartilage endplates can be useful for the diagnosis of early intervertebral disc degeneration and the prevention of disc degeneration.
使用 T2 映射成像技术测量腰椎软骨终板的 T2 值，旨在探讨 T2 值与椎间盘 Pfirrmann 分级之间的相关性。
共纳入 130 例因持续性腰痛而行腰椎 MR 检查的患者，包括 71 名男性和 59 名女性（年龄：21-63 岁）。49 例患者通过常规 T1WI 和 T2WI 图像识别腰椎 Modic 改变和 Schmorl 结节，将这些患者排除在研究之外。本研究共纳入 81 例患者，包括 45 名男性（45.16±12.20 岁）和 36 名女性（43.33±11.27 岁）。根据常规 T2WI 正中矢状位图像对每个腰椎间盘进行 Pfirrmann（Pm）分级，并通过 IDEAL-SPGR 图像确定软骨终板（CEP）的位置。同时，使用 T2 映射技术获得软骨终板的 T2 值。比较对应不同 Pm 级椎间盘的 CEP T2 值，并分析 T2 值与椎间盘 Pm 级之间的相关性。
Pm 分级 I-II、Pm 分级 III 和 Pm 分级 IV-V 组的 L 椎体头侧和尾侧 CEP 的 T2 值分别为 61.96±5.89ms、54.45±3.29ms、42.47±3.69ms 和 64.35±5.93ms、55.28±3.97ms、44.75±2.12ms。L 椎体头侧和尾侧 CEP 的 T2 值在 Pm 分级 I-II、Pm 分级 III 和 Pm 分级 IV-V 组中分别为 62.96±6.93ms、55.19±4.02ms、48.67±4.56ms 和 65.51±6.49ms、57.16±5.55ms、52.05±4.20ms。Pm 分级 I-II、Pm 分级 III 和 Pm 分级 IV-V 组从 L 到 L-S 椎体的头侧和尾侧 CEP 的 T2 值分别为（63.72±5.76ms、53.96±6.52ms、48.05±5.00ms）、（65.46±6.37ms、55.70±7.50ms、48.10±3.27ms）；（66.34±7.68ms、56.76±9.48ms、47.80±4.33ms）、（64.44±4.65ms、59.30±8.80ms、47.30±5.78ms）；（65.32±5.11ms、55.33±6.65ms、48.18±5.37ms）和（63.47±4.92ms、50.32±8.86ms、44.77±4.69ms）。椎间盘 Pm 分级 I-II、III 和 IV-V 之间的软骨终板 T2 值存在显著差异（P=0.000）。Pm I-II 级的 T2 值高于 Pm III 级，而 Pm IV-V 级的 T2 值最低。L 、L-S 节段终板的 T2 值与 Pm 分级呈高度相关（r=-0.711、-0.721、-0.796、-0.745；P=0.000），L 、L 终板的 T2 值呈中度相关（r=-0.542、-0.562、-0.637、-0.612；P=0.000）。
软骨终板的 T2 值显示出椎间盘不同程度的退变，退变越严重，T2 值越低。通过软骨终板测量 T2 值的变化可用于早期诊断椎间盘退变，并预防椎间盘退变。
