Assessment of Apparent Diffusion Coefficient in Normal and Degenerated Intervertebral Lumbar Disks: Initial Experience

Kealey, Susan; Aho, Todd; DeLong, David M.; Barboriak, Daniel P.; Provenzale, James M.; Eastwood, James D.

doi:10.1148/radiol.2352040437

Cited by 80 publications

(84 citation statements)

References 13 publications

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“…Although this study did not compute anisotropy measures, it did demonstrate differences in the directional apparent diffusion coefficient values, with the coefficient in the z direction (superior-inferior) showing no significant differences. At 1.5 T, Kealey et al (39) reported a 9% reduction in the ADC in abnormal discs compared with normal disc, a significant dependence of lumbar disc ADC on anatomical location (analysis of variance, p < 0.001), with lower ADC values seen in more caudal discs and no association between age and mean disc ADC.…”

Section: Mr Diffusion Measurementsmentioning

confidence: 98%

“…Quantitative T 1r imaging has been used in cartilage (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) and is affected by the interaction between motionally restricted water molecules and their macromolecular environment such as the glycosaminoglycan content. The extracellular matrix in the intervertebral disc may potentially be investigated using these techniques.…”

Section: Mri Relaxation Time Measurementsmentioning

confidence: 99%

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Magnetic resonance imaging and spectroscopy of the intervertebral disc

Majumdar

2006

NMR in Biomedicine

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Intervertebral disc disease is an emerging health concern and has a considerable negative effect on the economy and on society. MRI has a critical role in assessing the disc, but it is still a challenge to objectively correlate disc health and pain with images. In this paper, a review of MR disc imaging techniques including grading, relaxation time measurements, diffusion, and contrast perfusion is presented. In addition, high-resolution magic-angle spinning methods to correlate in vitro disc degeneration (with pain, etc) are discussed. With the potential for gaining morphological and biochemical information, MRI shows promise for quantitative assessment of disc health.

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Section: Mr Diffusion Measurementsmentioning

confidence: 98%

Section: Mri Relaxation Time Measurementsmentioning

confidence: 99%

Magnetic resonance imaging and spectroscopy of the intervertebral disc

Majumdar

2006

NMR in Biomedicine

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“…5,[20][21]34 This procedure may be of great value to researchers and clinicians who are interested in assessing physiologic changes in the IVD following intervention. Diffusion-weighted MRI scans differ from conventional T 1 , T 2 , and proton-density-weighted MRI scans in that they are designed to attenuate local differences in water diffusion rather than reflecting the specific anatomic characteristics of tissues.…”

mentioning

confidence: 99%

“…Diffusion-weighted MRI scans differ from conventional T 1 , T 2 , and proton-density-weighted MRI scans in that they are designed to attenuate local differences in water diffusion rather than reflecting the specific anatomic characteristics of tissues. 6,20 Diffusion weighting is achieved by the additional application of large, bipolar, gradient magnetic fields. The amount of diffusion weighting is denoted by a "b-value," with larger b-values resulting in increased diffusion weighting of the MR image (ie, higher sensitivity to the differences between regions of high and low diffusion).…”

mentioning

confidence: 99%

“…The amount of diffusion weighting is denoted by a "b-value," with larger b-values resulting in increased diffusion weighting of the MR image (ie, higher sensitivity to the differences between regions of high and low diffusion). 6,20,34 This results in a signal that is heavily weighted by diffusion and less influenced by local tissue composition. FIGURE 1 contrasts the differences in the appearance between a conventional midsagittal T 2 -weighted image and a midsagittal diffusion-weighted image obtained from the same subject.…”

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confidence: 99%

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Diffusion-Weighted Magnetic Resonance Imaging of Normal and Degenerative Lumbar Intervertebral Discs: A New Method to Potentially Quantify the Physiologic Effect of Physical Therapy Intervention

Beattie

Morgan²,

Peters³

2008

J Orthop Sports Phys Ther

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STUDY DESIGN: Observational, repeatedmeasures design. OBJECTIVES:To determine the reliability of the apparent diffusion coefficient (ADC) calculated from diffusion-weighted magnetic resonance images (MRI) of the nuclear region of lumbar intervertebral discs (IVDs), to investigate the differences in the ADC based upon T 2 -signal intensity, and to examine the test-retest variation in these measures obtained from subjects undergoing serial, diffusion-weighted MRI scans.BACKGROUND: Impaired diffusion of water within the lumbar IVD is a central characteristic of degenerative disc disease. Diffusion-weighted MRI scans can provide quantitative estimates of water diffusion and may be useful to evaluate the physiologic effects of healing or the change in hydration related to interventions such as traction, manual therapy, or exercise on normal and degenerative lumbar IVDs. METHODS:Thirty subjects underwent T 2 -weighted and diffusion-weighted lumbar MRI scans. Twenty-one of these subjects underwent a second diffusion-weighted MRI scan 4 to 7 weeks after the initial scan. The ADC was calculated from midsagittal diffusion-weighted images for the IVDs of L1-2 to L5-S1. To assess reliability, repeated measures of the ADC were performed on the first 16 scans. The T 2 -signal of the nuclear region of each disc was classified as hyperintense, intermediate, or hypointense, and its relationship to the mean ADC of the nuclear region was determined. Test-retest variation in the ADC was described using the coefficient of variation (CV), plus or minus the width of the 95% confidence interval of the standard error of measurement (SEM). RESULTS: Intraclass correlation coefficientsfor estimates of intrarater and interrater reliability ranged from 0.95 to 0.99 and the SEM ranged from 0.006 to 0.026 10 -3 mm 2 /s. The mean ADC was significantly greater for hyperintense IVDs compared to intermediate and hypointense IVDs. The CV plus or minus the 95% CI of the SEM between scans ranged from 9.0% to 13.6% for all discs, 6.1% to 10.1% for hyperintense discs, and 13.1% to 23.7% for intermediate discs. The prevalence of hypointense discs was too low to make meaningful judgments about their normal degree of variation over time. CONCLUSION:The ADC of the nuclear region of the lumbar IVDs may be reliably measured from diffusion-weighted images. Degenerative discs had lower mean ADC values than normal discs but demonstrated greater variation between scans. Diffusion-weighted imaging may be a useful procedure to assess change in diffusion of water in lumbar discs that occurs over time.

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Applications of Diffusion‐Weighted MRI to the Musculoskeletal System

Raya

Duarte

Wang

et al. 2023

Magnetic Resonance Imaging

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Diffusion‐weighted imaging (DWI) is an established MRI technique that can investigate tissue microstructure at the scale of a few micrometers. Musculoskeletal tissues typically have a highly ordered structure to fulfill their functions and therefore represent an optimal application of DWI. Even more since disruption of tissue organization affects its biomechanical properties and may indicate irreversible damage. The application of DWI to the musculoskeletal system faces application‐specific challenges on data acquisition including susceptibility effects, the low T2 relaxation time of most musculoskeletal tissues (2–70 msec) and the need for sub‐millimetric resolution. Thus, musculoskeletal applications have been an area of development of new DWI methods. In this review, we provide an overview of the technical aspects of DWI acquisition including diffusion‐weighting, MRI pulse sequences and different diffusion regimes to study tissue microstructure. For each tissue type (growth plate, articular cartilage, muscle, bone marrow, intervertebral discs, ligaments, tendons, menisci, and synovium), the rationale for the use of DWI and clinical studies in support of its use as a biomarker are presented. The review describes studies showing that DTI of the growth plate has predictive value for child growth and that DTI of articular cartilage has potential to predict the radiographic progression of joint damage in early stages of osteoarthritis. DTI has been used extensively in skeletal muscle where it has shown potential to detect microstructural and functional changes in a wide range of muscle pathologies. DWI of bone marrow showed to be a valuable tool for the diagnosis of benign and malignant acute vertebral fractures and bone metastases. DTI and diffusion kurtosis have been investigated as markers of early intervertebral disc degeneration and lower back pain. Finally, promising new applications of DTI to anterior cruciate ligament grafts and synovium are presented. The review ends with an overview of the use of DWI in clinical routine.Evidence Level5Technical EfficacyStage 3

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Assessment of Apparent Diffusion Coefficient in Normal and Degenerated Intervertebral Lumbar Disks: Initial Experience

Abstract: A statistically significant decrease was seen in the ADC values of degenerated lumbar disks when compared with ADC values of normal disks. More caudal disks, even when normal, showed lower ADC values than more cephalic disks.

Cited by 80 publications

References 13 publications

Magnetic resonance imaging and spectroscopy of the intervertebral disc

Magnetic resonance imaging and spectroscopy of the intervertebral disc

Diffusion-Weighted Magnetic Resonance Imaging of Normal and Degenerative Lumbar Intervertebral Discs: A New Method to Potentially Quantify the Physiologic Effect of Physical Therapy Intervention

Applications of Diffusion‐Weighted MRI to the Musculoskeletal System

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