Hon J Yu1,2, Shadfar Bahri3, Vance Gardner4, L Tugan Muftuler5. 1. John Tu and Thomas Yuen Center for Functional Onco-Imaging, University of California, Irvine Hall 164, Irvine, CA, 92697-5020, USA. hjyu@uci.edu. 2. Department of Radiological Sciences, University of California, Irvine, CA, 92697-5020, USA. hjyu@uci.edu. 3. John Tu and Thomas Yuen Center for Functional Onco-Imaging, University of California, Irvine Hall 164, Irvine, CA, 92697-5020, USA. 4. Orthopaedic Education and Research Institute of Southern California, Orange, CA, 92868, USA. 5. Department of Neurosurgery and Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Abstract
PURPOSE: To evaluate the role of apparent diffusion coefficient (ADC) as a quantitative means to assess the degree of intervertebral disc (IVD) degeneration contextually within the framework of a widely used Pfirrmann classification rather than in a direct correlation with Pfirrmann grades. METHODS: DWI and T2-weighted (T2w) of lumbar spine were acquired from nine healthy volunteers (age range 27-62 years, mean age 45 years) with a 3T MR scanner. ADC values were obtained from each of the five lumbar discs via a pixel-by-pixel ADC calculation as well as via region of interest-averaged image intensities. Disc degeneration was assessed by a scoring system via sequential application of Pfirrmann scale and use of intensity ratio of IVD/cerebrospinal fluid in T2w for discs in each Pfirrmann grade to be further separated. RESULTS: A significant correlation was observed between degenerative scores and ADC independent of how ADC was obtained (Spearman's ρ < -0.85, P < 2 × 10(-14)). CONCLUSIONS: This study demonstrates that previously perceived as an overlap in ADC value existing between different degenerative categories based on a visual inspection can be viewed as a quantitative role of ADC in assessment of disc degeneration. This reinforces the Pfirrmann classification system but also proceeds beyond mere qualitatively determining morphologic states.
PURPOSE: To evaluate the role of apparent diffusion coefficient (ADC) as a quantitative means to assess the degree of intervertebral disc (IVD) degeneration contextually within the framework of a widely used Pfirrmann classification rather than in a direct correlation with Pfirrmann grades. METHODS: DWI and T2-weighted (T2w) of lumbar spine were acquired from nine healthy volunteers (age range 27-62 years, mean age 45 years) with a 3T MR scanner. ADC values were obtained from each of the five lumbar discs via a pixel-by-pixel ADC calculation as well as via region of interest-averaged image intensities. Disc degeneration was assessed by a scoring system via sequential application of Pfirrmann scale and use of intensity ratio of IVD/cerebrospinal fluid in T2w for discs in each Pfirrmann grade to be further separated. RESULTS: A significant correlation was observed between degenerative scores and ADC independent of how ADC was obtained (Spearman's ρ < -0.85, P < 2 × 10(-14)). CONCLUSIONS: This study demonstrates that previously perceived as an overlap in ADC value existing between different degenerative categories based on a visual inspection can be viewed as a quantitative role of ADC in assessment of disc degeneration. This reinforces the Pfirrmann classification system but also proceeds beyond mere qualitatively determining morphologic states.
Entities:
Keywords:
Apparent diffusion coefficient; Degenerative disc disease; In vivo quantification of disc degeneration; Intervertebral disc degeneration; Lumbar spine; MRI
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