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Evaluation of Water Retention in Lumbar Intervertebral Disks Before and After Exercise Stress With T2 Mapping

Chokan, Kou, MD; Murakami, Hideki, MD; Endo, Hirooki, MD; Mimata, Yoshikuni, MD; Yamabe, Daisuke, MD; Tsukimura, Itsuko, MD; Oikawa, Ryosuke, MD; Doita, Minoru, MD

doi: 10.1097/BRS.0000000000001283
DIAGNOSTICS
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Study Design. T2 mapping was used to quantify moisture content of the lumbar spinal disk nucleus pulposus (NP) and annulus fibrosus before and after exercise stress, and after rest, to evaluate the intervertebral disk function.

Objective. To clarify water retention in intervertebral disks of the lumbar vertebrae by performing magnetic resonance imaging before and after exercise stress and quantitatively measuring changes in moisture content of intervertebral disks with T2 mapping.

Summary of Background Data. To date, a few case studies describe functional evaluation of articular cartilage with T2 mapping; however, T2 mapping to the functional evaluation of intervertebral disks has rarely been applied. Using T2 mapping might help detect changes in the moisture content of intervertebral disks, including articular cartilage, before and after exercise stress, thus enabling the evaluation of changes in water retention shock absorber function.

Methods. Subjects, comprising 40 healthy individuals (males: 26, females: 14), underwent magnetic resonance imaging T2 mapping before and after exercise stress and after rest. Image J image analysis software was then used to set regions of interest in the obtained images of the anterior annulus fibrosus, posterior annulus fibrosus, and NP. T2 values were measured and compared according to upper vertebrae position and degeneration grade.

Results. T2 values significantly decreased in the NP after exercise stress and significantly increased after rest. According to upper vertebrae position, in all of the upper vertebrae positions, T2 values for the NP significantly decreased after exercise stress and significantly increased after rest. According to the degeneration grade, in the NP of grade 1 and 2 cases, T2 values significantly decreased after exercise stress and significantly increased after rest.

Conclusion. T2 mapping could be used to not only diagnose the degree of degeneration but also evaluate intervertebral disk function.

Level of Evidence: 3

Department of Orthopedic Surgery, School of Medicine, Iwate Medical University, Morioka, Japan.

Address correspondence and reprint requests to Hideki Murakami, MD, Department of Orthopedic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 0208505, Japan; E-mail: lupin_punch520@yahoo.co.jp

Received 1 May, 2015

Revised 24 August, 2015

Accepted 24 September, 2015

Hideki Murakami contributed equally to the writing of this article.

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

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

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