Age dependent MRI findings of internal disc structure assessed by a detailed classification method

Congress:

ECR 2018

Poster Number:

C-1415

Type:

Scientific Exhibit

Keywords:

Musculoskeletal spine, Neuroradiology spine, MR, Normal variants, Diagnostic procedure, Education and training, Epidemiology

Authors:

K. Luoma¹, R. Luukkonen¹, T. vehmas¹, R. Raininko²; ¹Helsinki/FI, ²Uppsala/SE

DOI:

10.1594/ecr2018/C-1415

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1415

Fig. 1: Examples of findings on MR images of the discs of young (a-c) and middle-aged...

Table 1: Table 1. Visually evaluated signs of degeneration in the intervertebral discs...

Table 2: Table 2. Prevalences (%) of the most common combinations of degenerative MRI...

Table 3: Table 3. Prevalences (%) of the most common combinations of degenerative MRI...

Aims and objectives

Aims and objectives Different grading methods have been developed for classifying intervertebral disc degeneration on MRI. The degenerative MRI grades have been originally determined by comparing MRI slices with histological slices on cadaver studies and with biochemical analyses of tissue samples. A limited number of disc samples has been used as reference in vitro. Same criteria are used for subjects at any age and for discs at any level. MRI grades are chosen assuming that the degenerative process proceeds at the same pace in annulus...

Methods and materials

Subjects were 164 working men (machine drivers, concrete workers and office workers), aged 40-45 years, and 26 young men who had not had long lasting low back pain, aged 18-20 years. Sagittal T2-weighted (T2WI) and PD-weighted (PDWI) MR images of the lumbar spine were obtained at 0.01T using a dual echo (GE and SE sequence) technique (DE2000/25-86) with 2 acquisitions. The slice thickness was 7mm, FOV 410x410mm and the pixel size 1.6 x 1.6 mm. Lumbar discs from L2/L3 to L5/S1 were visually analyzed using...

Results

Results Interobserver agreement (weighted k) varied between 0.83 and 0.25 (n=190), according to the variable, disc level and pair of observers. It was good (0.60-0.79) or moderate (0.40-0.59) in most cases. Lowest values were found at L2/L3 level where most discs had mild degenerative changes only. Signal intensity of the disc was lower, size of the nuclear complex larger and intranuclear cleft thicker and more often irregular among middle aged than young men. Irregularity and inhomogeneity of the annulus fibrosus was relatively common among both...

Conclusion

A wide variation of morphologic types of discs was found using a detailed MRI classification of the internal disc structure. The most common combinations of MRI changes varied between young and middle-aged men and between upper and lower lumbar discs. The detailed MRI classification may be useful in differentiating age-dependent from pathologic disc degeneration in population studies on risk factors of disc degeneration. In genetic studies it may aid in finding the relevant combinations of MRI findings and thus characteristic phenotypes from the large pool...

Personal information

Katariina Luoma, clinical teacher in radiology, neuroradiologist,HUS Medical Imaging Center and University of Helsinki, Academic Medical Center Helsinki, Finland, [email protected]

References

[1]. Luoma K., Vehmas T., Riihimäki H., Raininko R. Disc height and signal intensity of the nucleus pulposus in MRI as indicators of lumbar disc degeneration. Spine 2001;26(6):680-86. [2]. Luoma K, Vehmas T, Raininko R, Luukkonen R, Riihimäki H. Lumbosacral transitional vertebra: Relation to disc degeneration and low back pain. Spine 2004;29(2):200-5. [3]. Solovieva S, Kouhia S, Leino-Arjas P, Ala-Kokko L, Luoma K, Raininko R, Saarela J, Riihimäki H. Interleukin 1 gene locus polymorphisms and intervertebral disc degeneration. Epidemiology 2004;15:626-33. [4]. Solovieva S. Lohiniva J,...