rammohan sai venkata vadapalli1, Raghav dutt sai venkata Mulukutla2, and abhinav sriiram Vadapalli3
1Imaging, Vijaya diagnostics and research, Hyderabad 500020, India, 2Orthopaedic and Spine surgery, Udai orthopaedic Institute, Hyderabad 500020, India, 3Imaging, GH, Hyderabad 500020, India
Synopsis
Surgeons
want to know Predictive disc health proximal to the level of fusion or
intervention.
Conventional
MR imaging using T2 weighted Imaging is insensitive to early morphological
changes with no predictive quantitative biomarker profile of early
degeneration.
The
Thompson scale or the Pfirrmann scale are discontinuous scales fail to
demonstrate the Degeneration or regeneration of disc Objectively.
Multiparametric Imaging using T2 relaxometry
maps,DTI indices namely FA and qualitative FA maps offer both quantitative and
qualitative biomarkers for predictive disc healthMaterials and Methods
seventy
Six age matched Controls (330 healthy discs) and seventy Six
patients in the age range of 29y-69 y, M:F ratio -2:3 ,mean -39 y were
studied during 2011-14
Controls
:3 subgroups: Young <30y (n=18) , Middle age < 50y(n=36);
old > 50-70yrs (n=22).
All
Patients (n=76) were Imaged on 3T MRI scanner ( Philips medical
Systems) A: T1 T2 sag ,T2 axial at the level of Disc
B.DTI
:15 directions ;B value 0,800, sag . T2 maps :
6 echoes with TEs of (15, 30, 60, 80,90, 120ms)
DTI
data was processed to generate FA , Fiber maps with 2 ROI
: AF(annulus Fibrosus) 2. NP (Nucleus pulposus) .
T2 data
analysed by ROIs in NP .
Data
computed and presented by correlation analysis
Results
Among
healthy controls, young people have higher T2 and AF/NP ratio than middle
aged, however, AF is not significantly different.Among healthy controls,
young people have higher T2 and AF/NP ratio but lower NP and AF than elderly.
Among
healthy controls, middle aged have higher T2 and AF/NP ratio but lower NP and
AF than elderly.
Among
patients, there are no differences between middle aged elderly.
Among
patients, young people have only higher T2 than middle aged/
Among
patients, young people have higher T2 and FA NP than elderly
AF/NP
has a strong correlation with age (years) in healthy controls but not in
Patients
CONCLUSION
DTI FA maps of NP/AF Ratio ; T2 values of NP are new biomarkers to provide microstructure of normal and degenerating discs for Predictive disc health ; detecting early degeneration facilitating better management
Clinical Relevance
Surgeons
want to know Predictive disc health proximal to the level of fusion or
intervention.
Conventional
MR imaging using T2 weighted Imaging is insensitive to early morphological
changes with no predictive quantitative biomarker profile of early
degeneration.
The
Thompson scale or the Pfirrmann scale are discontinuous scales fail to
demonstrate the Degeneration or regeneration of disc Objectively.
Multiparametric Imaging using T2 relaxometry
maps,DTI indices namely FA and qualitative FA maps offer both quantitative and
qualitative biomarkers for predictive disc health
Acknowledgements
Department of Spine surgery Udai clinics and research. Hyderabad India
Department of Radiology;VDC Hyderabad India
References
[1] Chiu EJ, et al., Spine, 2001.
26: E437–444.
[2] Schneiderman, G., et al.,
Spine, 1987. 12(3): p.276–281.
[3] Mori S et al. Ann Neurol,
1999.
45(2):p265-269.
[4] Jiang, H, et al.,
Comput
Meth
Programs Biomed, 2006. 81: p.106-16.
[5]
Marchan d F, et al., Spine, 1990. 15(5):p402-410.
6.Hsu EW
et al., Magn
Reson
Med, 1999. 41: p992–999. [7]
Mwale F, et al., Eur Spine J.,
2008, 17 Suppl
4:
p.432-44
7.Chan et al Proc.
Intl. Soc. Mag. Reson. Med. 18 (2010