Siriwananrangsun Palanan, Finkenstaedt Tim, Chen Karen C, Bae Won C
Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Department of Radiology, University of California-San Diego, San Diego, CA 921093, USA.
Tomography. 2025 Jan 23;11(2):12. doi: 10.3390/tomography11020012.
Chronic low back pain (LBP) has been associated with intervertebral disc (IVD) degeneration, but its association with abnormal morphology at the discovertebral junction (DVJ) is unclear. The goal of this study was to evaluate the DVJ morphology in asymptomatic (Asx) and symptomatic (Sx) subjects for LBP using ultrashort echo time (UTE) MRI. We recruited 42 subjects (12 Asx and 32 Sx). Lumbar IVD degeneration was assessed using Pfirrmann grading (1 to 5), while the abnormality of DVJ (0 = normal; 1 = focal; 2 = broad abnormality) was assessed using UTE MRI. The effects of LBP and level on the mean IVD and DVJ grades, the correlation between IVD and DVJ grade, and the effect of LBP and age on the number of abnormal DVJs within a subject were determined. IVD grade was higher in Sx subjects ( = 0.013), varying with disc level ( = 0.033), adjusted for age ( < 0.01). Similarly, DVJ grade was also significantly higher in Sx subjects ( = 0.001), but it did not vary with DVJ level ( = 0.7), adjusted for age ( = 0.5). There was a weak positive (rho = 0.344; < 0.001) correlation between DVJ and IVD grade. The total number of abnormal DVJs within a subject was higher in Sx subjects ( < 0.001), but not with respect to age ( = 0.6) due to a large spread throughout the age range. These results demonstrate the feasibility of using in vivo UTE MRI of the lumbar spine to evaluate the DVJ and the correlation of DVJ with LBP. This study highlights the need for a better understanding of DVJ pathology and the inclusion of DVJ assessment in routine lumbar MRI.
慢性下腰痛（LBP）与椎间盘（IVD）退变有关，但其与椎间盘椎体连接部（DVJ）形态异常的关联尚不清楚。本研究的目的是使用超短回波时间（UTE）磁共振成像（MRI）评估无症状（Asx）和有症状（Sx）的LBP受试者的DVJ形态。我们招募了42名受试者（12名Asx和32名Sx）。使用Pfirrmann分级（1至5级）评估腰椎IVD退变，而使用UTE MRI评估DVJ的异常情况（0 = 正常；1 = 局灶性；2 = 广泛异常）。确定了LBP和节段水平对平均IVD和DVJ分级的影响、IVD和DVJ分级之间的相关性，以及LBP和年龄对受试者体内异常DVJ数量的影响。Sx受试者的IVD分级更高（P = 0.013），随椎间盘节段水平而变化（P = 0.033），经年龄校正（P < 0.01）。同样，Sx受试者的DVJ分级也显著更高（P = 0.001），但经年龄校正（P = 0.5）后，其不随DVJ节段水平而变化（P = 0.7）。DVJ和IVD分级之间存在弱正相关（rho = 0.344；P < 0.001）。Sx受试者体内异常DVJ的总数更高（P < 0.001），但由于年龄范围分布广泛，与年龄无关（P = 0.6）。这些结果证明了使用腰椎的体内UTE MRI评估DVJ以及DVJ与LBP相关性的可行性。本研究强调了更好地理解DVJ病理学以及在常规腰椎MRI中纳入DVJ评估的必要性。
