Abraham Barnes Neil, Dkhar Winniecia, Kadavigere Rajagopal, Pradhan Abhimanyu
Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Med J Islam Repub Iran. 2025 Apr 21;39:57. doi: 10.47176/mjiri.39.57. eCollection 2025.
Degenerative disorders of the lumbar spine are a common cause of chronic pain and disability, particularly in older adults. They involve the progressive degeneration of intervertebral discs, which leads to symptoms such as lower back pain, nerve compression, and neurological deficits. While traditional MRIs are a widely used and effective tool for diagnosing many spinal conditions, including degenerative disorders of the lumbar spine, they do have limitations when it comes to detecting early microstructural changes in the intervertebral discs and other spinal components. This limitation can delay diagnosis and intervention in the early stages of degeneration, which is critical for preventing progression. The scoping review aims to sensitize the current evidence on the diagnostic performance of Diffusion Kurtosis Imaging (DKI) in detecting and characterizing degenerative changes in the lumbar spine.
Using the Arksey and O'Malley framework, we performed an extensive literature search across Scopus, Embase, and PubMed to identify relevant studies published between January 2010 and 2024. The selection criteria included 3T MRI studies utilizing DKI techniques aimed at evaluating degenerative changes in the lumbar spine.
The total number of studies included in this study was 3 out of 355, where our preliminary findings indicate that the DKI parameters demonstrated an early detection of microstructural changes within the degenerative lumbar spine as compared to the healthy controls. Accordingly, these changes are highly correlated with clinical symptoms and the extent of degeneration observed on conventional MRI, suggesting that DKI is more sensitive to detecting early microstructural changes.
MR Diffusion Kurtosis Imaging offers a substantial potential for detecting subtle microstructural changes in the lumbar spine degeneration at an early stage, that is crucial for earlier diagnosis and intervention. The integration of DKI sequence into clinical practice could result in an increase in diagnostic accuracy and patient outcomes.
腰椎退行性疾病是慢性疼痛和残疾的常见原因，在老年人中尤为如此。它们涉及椎间盘的渐进性退变，导致诸如腰痛、神经受压和神经功能缺损等症状。虽然传统磁共振成像（MRI）是诊断许多脊柱疾病（包括腰椎退行性疾病）的广泛使用且有效的工具，但在检测椎间盘和其他脊柱成分的早期微观结构变化方面确实存在局限性。这种局限性可能会延迟退变早期的诊断和干预，而这对于预防病情进展至关重要。本综述旨在梳理关于扩散峰度成像（DKI）在检测和表征腰椎退变方面诊断性能的现有证据。
我们使用阿克斯和奥马利框架，在Scopus、Embase和PubMed上进行了广泛的文献检索，以识别2010年1月至2024年期间发表的相关研究。选择标准包括利用DKI技术的3T MRI研究，旨在评估腰椎的退变变化。
本研究纳入的研究总数为355项中的3项，我们的初步研究结果表明，与健康对照组相比，DKI参数能够早期检测到退变腰椎内的微观结构变化。因此，这些变化与临床症状以及传统MRI上观察到的退变程度高度相关，这表明DKI在检测早期微观结构变化方面更敏感。
磁共振扩散峰度成像在早期检测腰椎退变中的细微微观结构变化方面具有巨大潜力，这对于早期诊断和干预至关重要。将DKI序列整合到临床实践中可能会提高诊断准确性和患者治疗效果。
