Magnetic resonance imaging (MRI) has been shown to improve the diagnosis and management of patients with intervertebral disc (IVD) related disorders. Multiparametric MRI offers the possibility of noninvasively assessing multiple aspects of pathophysiological processes that exist simultaneously, thereby further assisting in patient treatment management. The purpose of this study is to determine the correlation between relaxation parameters (T1ρ and T2), diffusion properties including fractional anisotropy (FA) and mean diffusivity (MD) measured by diffusion tensor imaging (DTI) and various clinical findings in human IVD. Our results suggest that each parameter may attribute different sensitivity to tissue properties.postprin

Anthony, MP

Chan, Q

Cheung, KMC

Khong, PL

Kim, M

Samartzis, D

HKU Scholars Hub

Multiparametric magnetic resonance imaging of normal and degenerative lumbar intervertebral discs

Introduction Magnetic resonance imaging (MRI) has been shown to improve the diagnosis and management of patients with intervertebral disk (IVD) related disorders. Multiparametric MRI offers the possibility of noninvasively assessing multiple aspects of pathophysiological processes that exist simultaneously, thereby further assisting in patient treatment management. The purpose of this study is to determine the correlation between relaxation parameters (T1-rho and T2), diffusion properties including fractional anisotropy (FA) and mean diffusivity (MD) measured by diffusion tensor imaging (DTI), and degenerative grades in human IVD based on T2-weighted MRI. Materials and Methods Total 21 subjects (mean age 41.3 years; age range: 24 to 61 years; gender: 10 females, 11 males) with no prior spine surgery were recruited. Sagittal T2-weighted, T1-rho, T2, FA and MD MRI of the lumbar spine were obtained. All images of the lumbar spine were acquired using a 3T Achieva scanner. High-resolution T2-weighted discs were qualitatively graded by two spine specialists in consensus according to Schneiderman's classification (score range: 0 to 3). T1-rho, T2, FA, and MD maps were quantitatively assessed based on a voxel-by-voxel basis. Results By visual inspection, the nucleus pulposus (NP) and annulus fibrosus (AF) in IVDs were distinctively separable on all quantitative maps while some of the discs on T2-weighted images did not show a clear difference between the NP and the AF. The Schneiderman grades and subjects' age significantly correlated with all parameters ( p &lt; 0.001). Univariate analysis demonstrated that T1-rho correlated significantly with MD and FA (r = 0.729 and −0.715, respectively; p &lt; 0.001 for both). Quantitative T2 also correlated significantly with MD and FA (r = 0.805 and −0.811, respectively; p &lt; 0.001 for both). In addition, T1-rho showed significant correlation with quantitative T2 (r = 0.824; p &lt; 0.001). Conclusion In this study, we performed quantitative multiparametric MRI to investigate its sensitivity to changes in tissue microstructure of in vivo human lumbar IVDs. Our results suggest that each imaging parameter may attribute different sensitivity to tissue properties. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared </jats:sec

M. Kim

Q. Chan

M. P. Anthony

D. Samartzis

K. Cheung

P. Khong

Crossref

Global Spine Journal

Multiparametric Magnetic Resonance Imaging of Normal and Degenerative Lumbar Intervertebral Disks

Title Multiparametric magnetic resonance imaging of normal anddegenerative lumbar intervertebral discsAuthor(s) Kim, M; Chan, Q; Anthony, MP; Samartzis, D; Cheung, KMC;Khong, PLCitationThe 20th Annual Meeting of the International Society forMagnetic Resonance in Medicine (ISMRM 2012), Melbourne, VC.,Australia, 5-11 May 2012. In International Society for MagneticResonance in Medicine Scientific Meeting and ExhibitionProceedings, 2012 , v. 20, p. 3330Issued Date 2012URL http://hdl.handle.net/10722/220292Rights Creative Commons: Attribution 3.0 Hong Kong LicenseMultiparametric magnetic resonance imaging of normal and degenerative lumbar intervertebral discs Mina Kim1, Queenie Chan2, Marina-Portia Anthony1, Dino Samartzis3, Kenneth MC Cheung3, and Pek-Lan Khong1 1Department of Diagnostic Radiology, University of Hong Kong, Hong Kong, SAR, China, People's Republic of, 2Philips Healthcare, Hong Kong, 3Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, SAR, China, People's Republic of  Objective: Magnetic resonance imaging (MRI) has been shown to improve the diagnosis and management of patients with intervertebral disc (IVD) related disorders. Multiparametric MRI offers the possibility of noninvasively assessing multiple aspects of pathophysiological processes that exist simultaneously, thereby further assisting in patient treatment management. The purpose of this study is to determine the correlation between relaxation parameters (T1ρ and T2), diffusion properties including fractional anisotropy (FA) and mean diffusivity (MD) measured by diffusion tensor imaging (DTI) and degenerative grades in human IVD.   Materials and Methods: After informed written consent was obtained, 21 subjects (mean age = 41.3 year; age range = 24-61 years; gender: 10 females, 11 males) with no prior spine surgery were recruited. All images of lumbar spine were acquired using a 3T Achieva scanner (Philips Healthcare, Best, The Netherlands) equipped with 40 mT/m gradients. RF was transmitted using the body coil and sensitivity encoding (SENSE) reception with the 8-element spine coil for human IVDs was employed. The T1ρ-weighted images were obtained with a 3D balanced turbo field echo (B-TFE) sequence with: TR/TE = 4.7ms/ 2.3 ms, flip angle= 30°, FOV= 180 x 200 mm2, slice thickness= 10 mm, 5 slices in a sagittal plane, acquired pixel size= 0.55 x 0.78 mm2, reconstructed pixel size= 0.52 x 0.52 mm2. 5 subsequent T1ρ-weighted scans were performed with spin-lock durations of 1, 25, 50, 75 and 100 ms and with a scan time of 1 min. 8 sec. for each scan. Quantitative T2 measurement in identical geometry as that of the T1ρ image was performed using standard multi-echo spin-echo sequence with TE= 30, 60, 90, 120 and 150 ms, acquired pixel size = 1.92 x 2.56 mm2, reconstructed pixel size = 1.25 x 1.26 mm2, FOV = 180 x 200 mm2, slice thickness = 10 mm, single slice in a sagittal plane, and scan time = 2 min. 20 sec. 4 averaged minimally weighted (b0) and 15 non-collinear diffusion-encoding directions (b-value = 500 s/mm2) which cover up to 5 levels of IVDs (L1/L2 to L5/S1) in sagittal plane were acquired using single shot EPI sequence. The imaging parameters were: TR = 3000 ms, TE = 71 ms, FOV = 180 x 72 mm2, acquisition matrix = 180 x 141, reconstructed resolution = 0.625 x 0.625 mm2, EPI factor = 71, 12 slices, slice thickness = 5 mm, gap = 1 mm, 4 averages and total scan time = 6 min. 24 sec. T2w images with same geometry as the DTI acquisition (low-resolution T2w) were obtained in order to identify regions of interest (ROIs). Additionally, high-resolution T2w images in sagittal plane were obtained for radiologic assessment of disc degeneration with: TR = 2500 ms, TE = 90 ms, FOV = 72 x 180 mm2, acquisition matrix = 88 x 191, reconstructed resolution = 0.625 x 0.625 mm2, 12 slices, slice thickness = 5 mm, gap = 1 mm, 2 averages and total scan time = 2 min. Using high-resolution T2w, discs were graded by two spine specialists in consensus according to Schneiderman’s classification (score range: 0 to 3) [1]. For data analysis, a custom-written program in Matlab (Mathworks, Natick, MA, USA) was used. Staistical analyses were performed with SPSS vr. 18.0 (Chicago, IL)    Results: Figure illustrates representative multi-parametric MR images (T2w, T1ρ, T2, FA and MD) covering multiple lumbar disc levels (top to bottom) for a 28-year-old female subject. Degenerative disc disease (DDD) grades were determined on T2w image by qualitative assessment criteria. On the contrary, T1ρ, T2, FA and MD maps quantitative differences on a voxel-by-voxel basis. By visual inspection, the nucleus pulposus (NP) and annulus fibrosus (AF) in IVDs were distinctively separable on the all quantitative maps while some of discs on T2w images did not show clear difference between the NP and the AF. Table shows that Schneiderman grades and subject’s age significantly correlated with all parameters (p<0.001). Univariate analysis demonstrated that T1ρ correlated significantly with MD and FA (r = 0.729 and -0.715, respectively; p<0.001 for both). T2 also correlated significantly with MD and FA (r = 0.805 and -0.811, respectively; p<0.001 for both). In addition, T1ρ showed significant correlation with T2 (r = 0.824; p<0.001).  Conclusion: In this study, we performed quantitative multiparametric MRI to investigate its sensitivity to changes in tissue microstructure of in vivo human lumbar IVDs. Our results suggest that each parameter may attribute different sensitivity to tissue properties.  References: [1] Schneiderman et al., 1987.  T1ρ T2 MD FA DDD -0.674 (< .001) -0.713 (< .001) -0.735 (< .001) -0.761 (< .001) Age -0.753 (< .001) -0.834 (< .001) -0.529 (< .001) 0.603 (< .001) 3330Proc. Intl. Soc. Mag. Reson. Med. 20 (2012)

INTRODUCTION: Magnetic resonance imaging (MRI) has been shown to improve the diagnosis and management of patients with intervertebral disk (IVD) related disorders. Multiparametric MRI offers the possibility of noninvasively assessing multiple aspects of pathophysiological processes that exist simultaneously, thereby further assisting in patient treatment management. The purpose of this study is to determine the correlation between relaxation parameters (T1-rho and T2), diffusion properties including fractional anisotropy (FA) and mean diffusivity (MD) measured by diffusion tensor imaging (DTI), and degenerative grades in human IVD based on T2-weighted MRI. MATERIALS AND METHODS: Total 21 subjects (mean age 41.3 years; age range: 24 to 61 years; gender: 10 females, 11 males) with no prior spine surgery were recruited. Sagittal T2-weighted, T1-rho, T2, FA and MD MRI of the lumbar spine were obtained. All images of the lumbar spine were acquired using a 3T Achieva scanner. High-resolution T2-weighted discs were qualitatively graded by two spine specialists in consensus according to Schneiderman's classification (score range: 0 to 3). T1-rho, T2, FA, and MD maps were quantitatively assessed based on a voxel-by-voxel basis. RESULTS: By visual inspection, the nucleus pulposus (NP) and annulus fibrosus (AF) in IVDs were distinctively separable on all quantitative maps while some of the discs on T2-weighted images did not show a clear difference between the NP and the AF. The Schneiderman grades and subjects' age significantly correlated with all parameters (p < 0.001). Univariate analysis demonstrated that T1-rho correlated significantly with MD and FA (r = 0.729 and −0.715, respectively; p < 0.001 for both). Quantitative T2 also correlated significantly with MD and FA (r = 0.805 and −0.811, respectively; p < 0.001 for both). In addition, T1-rho showed significant correlation with quantitative T2 (r = 0.824; p < 0.001). CONCLUSION: In this study, we performed quantitative multiparametric MRI to investigate its sensitivity to changes in tissue microstructure of in vivo human lumbar IVDs. Our results suggest that each imaging parameter may attribute different sensitivity to tissue properties.link_to_OA_fulltex

Cheung, K

Khong, P

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Multiparametric magnetic resonance imaging of normal and degenerative lumbar intervertebral discs

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