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T1 Magnetic Resonance Imaging Quantification of Early Lumbar Intervertebral Disc Degeneration in Healthy Young Adults

Zobel, Bruno Beomonte MD; Vadalà, Gianluca MD; Del Vescovo, Riccardo MD; Battisti, Sofia MD; Martina, Francesca Maria MD; Stellato, Luigi MD; Leoncini, Emanuele PhD; Borthakur, Arijitt PhD; Denaro, Vincenzo MD

doi: 10.1097/BRS.0b013e31824b2450
Diagnostics

Study Design. Cross-sectional study using T magnetic resonance imaging (MRI) of lumbar spine in healthy young adults.

Objective. To evaluate early intervertebral disc degeneration (IDD) quantified by T- and T2-weighted MRI in asymptomatic young adults and to correlate T value with Pfirrmann degenerative grade, sex, and body mass index (BMI).

Summary of Background Data. Intervertebral disc starts early to degenerate losing proteoglycan content in the nucleus pulposus (NP). A potential tool for the study of early stage of IDD is T MRI. T relaxation time of human discs has been correlated to proteoglycan content in previous studies.

Methods. T- and T2-weighted images of the lumbar spine were obtained for 63 asymptomatic young subjects (34 men and 29 women; mean age, 22.95 ± 1.8 yr), with a 1.5-T MRI scanner. T mapping and values in the NP and anulus fibrosus (n = 315) were obtained. Degenerative grade was assessed using T2-weighted images, according to the Pfirrmann scale. Differences in T value between sexes, BMI, and linear regression analyses with degenerative grade were determined.

Results. T values of NPs were significantly higher than those of anulus fibrosus at all levels. T values were significantly lower in women at L3–L4 and L4–L5 discs (P < 0.05). T values decreased linearly with degenerative grade. However, nondegenerated discs (Pfirrmann grades 1 and 2) showed a wide range of T relaxation time. No significant correlation was observed between T value and BMI.

Conclusion. The data of this study showed a significant difference in IDD onset between sexes. T values correlate with Pfirrmann degenerative grade in young adults. However, the wide distribution of T values in healthy intervertebral disc highlights the low sensitivity of Pfirrmann grade to detect the early IDD changes. T can be potentially used as a clinical tool to identify early IDD and to create a reliable quantitative scale.

Early intervertebral disc degeneration (IDD) was evaluated in healthy young adults, with T1ρ magnetic resonance imaging. T1ρ values were significantly lower in women, showing a difference in IDD onset between sexes. T1ρ value correlates with Pfirrmann degenerative grade highlighting the low sensitivity of Pfirrmann grade to detect the early IDD changes.

Departments of *Radiology and;

Orthopaedic and Trauma Surgery, Campus Bio-Medico University Hospital of Rome, Italy, Rome, Rome, Italy;

Sapienza University of Rome, Rome, Italy; and

§CMROI, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.

Address correspondence and reprint requests to Gianluca Vadalà, MD, Department of Orthopedic and Trauma Surgery, Campus Bio-Medico University Hospital of Rome, Italy, Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy; E-mail: g.vadala@gmail.com

Acknowledgment date: May 16, 2011. First revision date: September 22, 2011. Second revision date: November 16, 2011. Acceptance date: November 21, 2011.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.