MRI T2* mapping correlates with biochemistry and histology in intervertebral disc degeneration in a large animal model

Detiger, Suzanne E. L.; Holewijn, Roderick M.; Hoogendoorn, Roel J. W.; Royen, Barend J. van; Helder, Marco N.; Berger, Ferco H.; Kuijer, Joost P.A.; Smit, Theo H.

doi:10.1007/s00586-014-3498-1

Cited by 41 publications

(45 citation statements)

References 31 publications

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“…Although MRI has been successful in diagnosing later stages of IVD degeneration, early degenerative changes in the disc matrix, even with enhanced MRI, only correlate moderately with tissue histology [9]. In the present study, some histological and microscopic features, such as fibre angle changes at the IVD-CEP junction and loss of disc integrity, appeared to reflect the disc bulging and change in signal and loss of AF and NP distinction observed on the MRIs.…”

Section: Discussioncontrasting

confidence: 49%

Staying connected: structural integration at the intervertebral disc–vertebra interface of human lumbar spines

et al. 2016

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Purpose:To investigate the microscopic fibrous integration between the intervertebral disc, cartilage endplates and vertebral endplates in human lumbar spines of varying degrees of degeneration using differential interference contrast (DIC) optics. Weakness at these junctions is considered to be an important factor in the aetiology of disc herniations. Methods:Magnetic resonance images (MRIs) of cadaveric lumbar spines were graded for degeneration and motion segments from a range of degenerative grades isolated and bisected sagittally. Following fixation and decalcification, these were cut into segments containing anterior or posterior annulus fibrosus or nucleus pulposus. The segments were cryo-sectioned and sections visualised using both standard light and DIC microscopy. Results:Detachment at the interface between the disc and vertebrae increased with greater degenerative grade (from 1.9% in Grade I to 28% in Grade V), especially at the boundary between the cartilage and vertebral endplates. DIC microscopy revealed the fibrous organisation at the IVD-cartilage endplate interface with structural features, such as annular lamellae branching and nodal insertions in the nucleus pulposus region; these have been previously observed in ovine spines, but were less uniform in humans.Structural integrity of the IVD and cartilage endplate was also lost with increasing degeneration. Conclusions:This preliminary study shows that microscopic structural features may act to maintain attachment between the IVD and CEP in the human spine. Loss of structural integrity in this region may destabilise the spine, possibly altering the mechanical environment of the cells in the disc and so potentially contribute to the aetiopathogenesis of IVD degeneration.

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Section: Discussioncontrasting

confidence: 49%

Staying connected: structural integration at the intervertebral disc–vertebra interface of human lumbar spines

et al. 2016

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“…Recent studies have demonstrated the low-to-moderate correlation between T2 ∗ value and Pfirrmann grade, as well as T2 ∗ value and GAG content in IVDD. [10,11] Previous study groups also reported a significant negative correlation of degeneration signs and T2 ∗ values. [10,20,21] In the present study, T2 ∗ values were negatively correlated with Pfirrmann grades ( r = −0.673, P < 0.000).…”

Section: Discussionmentioning

confidence: 89%

“…[13,14] Previous studies have demonstrated the feasibility of IVD assessment with T2 ∗ values, [10] histological correlation of the T2 ∗ values and degree of degeneration, [11] and biochemical correlation of the T2 ∗ values and low glycosaminoglycan (GAG) content with decreased lumbar mechanical function. [12] Detiger et al [11] validated T2 ∗ mapping for disc degeneration by correlating this technique with accepted parameters of IVD degeneration with biochemical assays and macroscopic and histological scoring by using 48 goat IVDs. The results confirmed that a linear positive correlation was observed between T2 ∗ relaxation time and GAG content ( r = 0.64), Pfirrmann grades ( r = −0.67), macroscopic ( r = −0.33) and histological ( r = −0.45) findings.…”

Section: Introductionmentioning

confidence: 99%

Correlation between T2* (T2 star) relaxation time and cervical intervertebral disc degeneration

Huang

Guo

et al. 2016

Medicine

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Purpose:To demonstrate the potential benefits of T2∗ relaxation time of intervertebral discs (IVDs) regarding the detection and grading of degenerative disc disease using 3.0-T magnetic resonance imaging (MRI) in a clinical setting.Materials and Methods:Cervical sagittal T2-weighted, T2∗ relaxation MRI was performed at 3.0-T in 61 subjects, covering discs C2–3 to C6–7. All discs were morphologically assessed based on the Pfirrmann grade, and regions of interests (ROIs) were drawn over the T2∗ mapping. Receiver operating characteristic (ROC) analysis was performed among grades to determine the cut-off values.Results:Cervical intervertebral discs (IVDs) of patients were commonly determined to be at Pfirrmann grades III to V. The nucleus pulposus (NP) values did not differ significantly between sexes at the same anatomic level (P > 0.05). In the NP, the T2∗ values tended to decrease with increasing grade (P < 0.000), and a significant difference was found in the T2 values between grades I to V (P < 0.05). T2∗ values based on disc degeneration level classification were as follows: grade I (>30 milliseconds), grade II (24.55–29.99 milliseconds), grade III (21.65–24.54 milliseconds), grade IV (18.35–21.64 milliseconds), and grade V (<18.34 milliseconds).Conclusion:Our standardized method of region-specific quantitative T2∗ relaxation time evaluation seems capable of characterizing different degrees of disc degeneration quantitatively. The T2∗ values obtained in these cervical IVDs may serve as baseline values for future T2∗ measurements in both healthy and degenerated cervical discs.

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“…Differences between the two studies are likely because of geometrical differences in disc height and volume (disc height: caprine ¼ 3-4 mm, bovine ¼ 7 mm), 32,36 as the disc area, glycosaminoglycan content, and water composition are comparable between the two species ($600-680 mm 2 , $600 mg/mg dry weight). [36][37][38] Establishing a relationship between disc behavior and external osmotic pressure will be helpful for measuring intradiscal pressure without the use of pressure sensors, which might alter disc mechanics because of annular injuries. 39 The bovine caudal disc is an ideal animal model to study disc mechanics of the healthy human disc, based on similarities in biomechanical composition, disc height, swelling pressure, and mechanical properties.…”

Section: Discussionmentioning

confidence: 99%

Osmotic Pressure Alters Time-dependent Recovery Behavior of the Intervertebral Disc

Bezci

O’Connell

2018

Spine

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Study Design. Disc recovery behavior under hypo-and hyperosmotic pressure. Objective. To evaluate the effect of osmotic pressure on the unloaded recovery response of healthy discs. Summary of Background Data. The intervertebral disc is a poroviscoelastic material that experiences large fluctuations in water composition throughout a diurnal loading cycle. Fluid flow out of the disc occurs through mechanical loading, whereas fluid flow into the disc occurs through passive diffusion because of an imbalance of ions between the disc and its surrounding environment. Osmotic pressure has been used to alter water uptake and tissue hydration. Methods. Motion segments were prepared from the caudal spine sections of the skeletally mature bovines. A 300-N compressive load was applied for 2 hours before unloaded recovery for 12 hours. Hypo-and hyperosmotic pressure was used to alter the rate of water uptake and disc height recovery during unloaded recovery. A 5-parameter rheological model was used to describe the disc's time-dependent recovery behavior. Results. The elastic response was not altered by changes in osmotic pressure; however, viscoelastic recovery was highly dependent on saline osmolarity and recovery time. The fast response of viscoelastic recovery was not dependent on osmotic pressure. The time constant for the slow response decreased whereas the slow response stiffness increased as osmotic pressure increased.Conclusion. The fast response of viscoelastic recovery is governed by flow-independent recovery, whereas the slow response is related to flow-dependent recovery. The rate and magnitude of flow-dependent recovery are highly sensitive to changes in osmotic pressure of the saline bath. There is an osmotic pressure that reduces disc recovery behavior to an elastic response or flow-independent recovery.

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MRI T2* mapping correlates with biochemistry and histology in intervertebral disc degeneration in a large animal model

Cited by 41 publications

References 31 publications

Staying connected: structural integration at the intervertebral disc–vertebra interface of human lumbar spines

Staying connected: structural integration at the intervertebral disc–vertebra interface of human lumbar spines

Correlation between T2* (T2 star) relaxation time and cervical intervertebral disc degeneration

Osmotic Pressure Alters Time-dependent Recovery Behavior of the Intervertebral Disc

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