Korean J Radiol.  2015 Feb;16(1):139-145. 10.3348/kjr.2015.16.1.139.

Segmental Quantitative MR Imaging Analysis of Diurnal Variation of Water Content in the Lumbar Intervertebral Discs

• Zhu T
• Ai T
• Zhang W
• Li T
• Li X

• KMID: 2069992
• DOI: http://doi.org/10.3348/kjr.2015.16.1.139

Abstract

OBJECTIVE
To investigate the changes in water content in the lumbar intervertebral discs by quantitative T2 MR imaging in the morning after bed rest and evening after a diurnal load.
MATERIALS AND METHODS
Twenty healthy volunteers were separately examined in the morning after bed rest and in the evening after finishing daily work. T2-mapping images were obtained and analyzed. An equally-sized rectangular region of interest (ROI) was manually placed in both, the anterior and the posterior annulus fibrosus (AF), in the outermost 20% of the disc. Three ROIs were placed in the space defined as the nucleus pulposus (NP). Repeated-measures analysis of variance and paired 2-tailed t tests were used for statistical analysis, with p < 0.05 as significantly different.
RESULTS
T2 values significantly decreased from morning to evening, in the NP (anterior NP = -13.9 ms; central NP = -17.0 ms; posterior NP = -13.3 ms; all p < 0.001). Meanwhile T2 values significantly increased in the anterior AF (+2.9 ms; p = 0.025) and the posterior AF (+5.9 ms; p < 0.001). T2 values in the posterior AF showed the largest degree of variation among the 5 ROIs, but there was no statistical significance (p = 0.414). Discs with initially low T2 values in the center NP showed a smaller degree of variation in the anterior NP and in the central NP, than in discs with initially high T2 values in the center NP (10.0% vs. 16.1%, p = 0.037; 6.4% vs. 16.1%, p = 0.006, respectively).
CONCLUSION
Segmental quantitative T2 MRI provides valuable insights into physiological aspects of normal discs.

Keyword

Spine; Intervertebral disc; T2 mapping; Quantitative MRI

MeSH Terms

Adult
Female
Humans
Image Processing, Computer-Assisted
Intervertebral Disc/*radiography
Lumbar Vertebrae/*radiography
Magnetic Resonance Imaging
Male
Water/*chemistry
Water

Figure

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  Fig. 1 Height from upper anterior edges of L1 to S1 in morning (M) and evening (E) was measured on sagittal T2-weighted images.

• 

  Fig. 2 Subregional segmentation of intervertebral disc. Disc was divided into 5 equal portions from anterior to posterior in midsagittal plane. Each region-of-interest (ROI) measured about 20% of disc diameter. ROI1 was placed on anterior annulus fibrosus (AF), ROI5 on posterior AF, and ROIs 2 to 4 on anterior nucleus pulposus (NP), central NP, and posterior NP, respectively.

• 

  Fig. 3 Colored T2 maps of lumbar intervertebral discs in morning (A) and evening (B) show evident change of T2 values in central parts of lumbar vertebral discs from morning to evening.

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  Fig. 4 Mean T2 values (milliseconds) for different ROIs of IVDs. From morning to evening after daily activities, average T2 values were significantly decreased in ROI2 to ROI4 (NP portion of disc), and significantly increased in ROI1 and ROI5 (AF portion of disc). AF = annulus fibrosus, IVDs = intervertebral discs, NP = nucleus pulposus, ROI = region-of-interest

• 

  Fig. 5 Degree of T2 variation in different compartments of disc from morning to evening. Biggest change in degree was found in posterior AF (ROI5) and smallest was in posterior NP (ROI4). AF = annulus fibrosus, NP = nucleus pulposus, ROI = region-of-interest

• 

  Fig. 6 Relative variation in discs with low and high CNP T2 values from morning to evening. Compared to those discs with high CNP T2 values, discs IVDs with low CNP T2 values, showed smaller degree of T2 variation in NP and increasing trend in degree of T2 time variation in AF. AF = annulus fibrosus, CNP = central nucleus pulposus, IVDs = intervertebral discs, NP = nucleus pulposus, ROI = region-of-interest

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