Bhari Thippeswamy Pushpa, Rajasekaran Shanmuganathan, Ramachandran Karthik, Easwaran Murugesh, Ramadevi Shalini Sivakumar, Sri Vijay Anand K S, Shetty Ajoy Prasad, Mugesh Kanna Rishi
Department of Radiodiagnosis, Ganga Hospital, Coimbatore, India.
Department of Spine Surgery, Ganga Hospital, Coimbatore, India.
Global Spine J. 2024 Dec 21:21925682241311515. doi: 10.1177/21925682241311515.
Observational comparative study.
To study the role of magnetic resonance spectroscopy (MRS) and T2 relaxometry (T2r) as imaging biomarkers for identifying early lumbar disc degeneration.
We evaluated 236 discs in normal volunteers and 215 discs in low back pain (LBP) patients by MRS and T2r to document the molecular spectra of various metabolites as well as disc hydration and collagen content, respectively. All volunteer discs were Pfirrmann grade 1 (PF1), whereas patients with LBP had PF 1 (n = 156) and PF 2 (n = 59). The study population was compared in three age groups: A (20-30 years), B (30-40 years), and C (40-50 years).
T2r, an indicator of collagen and hydration, was higher in volunteers (121.8 ± 31.1), compared to PF 1 patients (110.68 ± 23.96) and PF 2 patients (90.15 ± 25.81) ( = 0.001). Proteoglycan assessed by MRS was more stable for volunteers (3.39 ± 1.69) and PF 1 patients (3.6 ± 1.69) but reduced in PF 2 patients (2.86 ± 1.47), showing that structural molecules did not alter within the PF 1. However, lactate and other metabolites showed a difference even within PF1 between volunteers and LBP patients. We were able to identify a unique subset of PF 1 that had a normal value of proteoglycan and T2r but altered metabolite distribution, which may represent early disc degeneration (DD).
MRS and T2r can be used as imaging biomarkers for early DD by identifying altered metabolic activity with an intact matrix.
观察性比较研究。
研究磁共振波谱（MRS）和T2弛豫测量法（T2r）作为识别早期腰椎间盘退变的影像生物标志物的作用。
我们通过MRS和T2r分别评估了正常志愿者的236个椎间盘以及腰痛（LBP）患者的215个椎间盘，以记录各种代谢物的分子光谱以及椎间盘的含水量和胶原蛋白含量。所有志愿者的椎间盘均为Pfirrmann 1级（PF1），而LBP患者有PF1（n = 156）和PF2（n = 59）。研究人群按三个年龄组进行比较：A组（20 - 30岁）、B组（30 - 40岁）和C组（40 - 50岁）。
作为胶原蛋白和含水量指标的T2r，在志愿者中（121.8 ± 31.1）高于PF1患者（110.68 ± 23.96）和PF2患者（90.15 ± 25.81）（P = 0.001）。通过MRS评估的蛋白聚糖在志愿者（3.39 ± 1.69）和PF1患者（3.6 ± 1.69）中更稳定，但在PF2患者中降低（2.86 ± 1.47），表明在PF1范围内结构分子未发生改变。然而，乳酸和其他代谢物在志愿者和LBP患者的PF1内也显示出差异。我们能够识别出PF1的一个独特亚组，其蛋白聚糖和T2r值正常，但代谢物分布改变，这可能代表早期椎间盘退变（DD）。
MRS和T2r可通过识别完整基质中改变的代谢活性，用作早期DD的影像生物标志物。
