Study Design. Cross-sectional study using T1ρ magnetic resonance imaging (MRI) of lumbar spine in healthy young adults.
Objective. To evaluate early intervertebral disc degeneration (IDD) quantified by T1ρ- and T2-weighted MRI in asymptomatic young adults and to correlate T1ρ 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 T1ρ MRI. T1ρ relaxation time of human discs has been correlated to proteoglycan content in previous studies.
Methods. T1ρ- 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. T1ρ 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 T1ρ value between sexes, BMI, and linear regression analyses with degenerative grade were determined.
Results. T1ρ values of NPs were significantly higher than those of anulus fibrosus at all levels. T1ρ values were significantly lower in women at L3–L4 and L4–L5 discs (P < 0.05). T1ρ values decreased linearly with degenerative grade. However, nondegenerated discs (Pfirrmann grades 1 and 2) showed a wide range of T1ρ relaxation time. No significant correlation was observed between T1ρ value and BMI.
Conclusion. The data of this study showed a significant difference in IDD onset between sexes. T1ρ values correlate with Pfirrmann degenerative grade in young adults. However, the wide distribution of T1ρ values in healthy intervertebral disc highlights the low sensitivity of Pfirrmann grade to detect the early IDD changes. T1ρ 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: firstname.lastname@example.org
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.