The Relationship Between Morphology of Lumbar Disc Herniation and MRI Changes in Adjacent Vertebral Bodies (original) (raw)
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Natural history of extruded lumbar intervertebral disc herniation
The Journal of Medical Investigation
We studied the natural history of extruded lumbar intervertebral discs using MRI. Forty-nine patients with lumbar disc herniation were included in this study. Ages ranged from 19 to 57. On the T2-weighted sagittal MR image, the signal intensity in the herniated mass was measured and the ratio to that in the original nucleus (i.e., nucleus pulposus from which they extruded) was calculated (signal intensity ratio; SIR). The relationship with SIR and duration of illness was evaluated. In ten patients who were re-examined by MRI after conservative treatment, the size of the herniation measured by T1-weighted axial MR image was compared before and after treatment. The signal intensity of HNP became higher than that of the original nucleus immediately following herniation and thereafter decreased with time, suggesting that initial hydration of the HNP occurred shortly after herniation followed by dehydration of the HNP. The size of the HNP with a SIR value of 1.2 and higher on T2-weighted...
European …, 2010
Objective To assess the relationship of morphologically defined lumbar disc abnormalities with quantitative T2 mapping. Methods Fifty-three patients, mean age 39years, with low back pain were examined by MRI at 3T (sagittal T1-fast spin echo (FSE), three-plane T2-FSE for morphological MRI, multi-echo spin echo for T2 mapping). All discs were classified morphologically. Regions of interest (ROIs) for the annulus were drawn. The space in between was defined as the nucleus pulposus (NP). To eval-uate differences between the classified groups, univariate ANOVA with post hoc Games-Howell and paired two-tailed t tests were used. Results In 265 discs we found 39 focal herniations, 10 annular tears, 123 bulging discs and 103 "normal discs". T2 values of the NP between discs with annular tear and all other groups were statistically significantly different (all p≤0.01). Discs with annular tears showed markedly lower NP T2 values than discs without. The difference in NP T2 values between discs with focal herniation and normal discs (p=0.005) was statistically significant. There was no difference in NP T2 values between bulging and herniated discs (p=0.11) Conclusion Quantitative T2 mapping of the nucleus pulposus of the intervertebral disc in the lumbar spine at 3T reveals significant differences in discs with herniation and annular tears compared with discs without these abnormalities.
Disc Prolapses In The Spine on Magnetic Resonance Imaging
Pakistan Journal of Health Sciences
A disc herniation occurs when the nucleus, cartilage, or fragmented annular tissue are displaced outside the intervertebral disc area. Because of its high sensitivity and specificity for disc herniations, MRI is the method of choice for assessing disc morphology (both protrusions and extrusion).Objective: To use MRI to diagnose disc disorders, to create optimal MRI sequences for diagnosing spine pathologies, to detect which gender was affected, and to correlate the spinal disc with patient age.Methods:It was a descriptive cross-sectional study carried out in a DHQ Hospital, Gujranwala, Pakistan and the sample size for this research was 71 calculated via a convenient sampling approach. The data were collected in four months from December 2021 to March 2022 after informed consent. Patients who presented to the MRI department for spinal disc prolapse were included in this study. Patients were to be registered with age, gender, type of examination, and protocol used. An MRI scanner was ...
Magnetic Resonance Imaging, 1994
Since relaxation times are influenced by the hydration of the tissue and the chemical environment of the water molecules, Tr and T2 measurements (quantitative MRI) could be used as an indicator for the water content and the biochemical composition of lumbar intervertebral discs. The discriminating power of quantitative MRI for tissue characterization in individuals (for clinical diagnosis) and in cohorts (e.g. for investigations on disc physiology or composition) relies on the reproducibility in relation to the expected tissue differences. We therefore investigated the reproducibility in vitro (lumbar spine phantom) and in vivo (10 volunteers). To estimate the differences between normal and pathologic tissues in vivo, 100 normal and 20 herniated intervertebral discs were examined by quantitative MRI in a first application of our method. The relaxation times were calculated from a set of 20 images obtained with five singe-slice/multi-echo sequences at different TR values on a commercial whole-body system (1.5 T). We have found a satisfactory reproducibility in vitro (Tr: 1.9%; T2: 6.2%), while the reproducibility was less satisfactory in vivo (T,: 16.4%; T,: 13.4%). Calculated from theses values, differences in relaxation times of various tissues must exceed 486 ms for T, and 24 ms for T2 (tolerance limits) to allow discrimination with a 95% confidence in individuals. We observed statistically significant (p = 0.001) mean differences between normal (n = 100) and herniated (n = 20) intervertebral discs (AT,: 196 ms; AT,: 15 ms). Although statistical significant in cohorts, a discrimination of normal and herniated intervertebral discs is limited by quantitative MRI in individuals, since the differences are smaller than the tolerance limits necessary for a reliable clinical diagnosis. However, our results indicate that variations in the disc hydration and/or composition can be noninvasively detected by quantitative MRI in studies of cohorts with sufficient accuracy.
The limited protocol MRI in diagnosis of lumbar disc herniation
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006
To assess agreement in detection of lumbar disc herniation (LDH) between limited and full protocol MRI. 123 patients who requested lumbar MRI for diagnosis of disc herniation were assessed The full protocol MRI composed of sagittal T1-wi, sagittal T2-wi and axial T2-wi was performed on each patient. The sagittal T2-wi was selected as the limited protocol MRI. The limited and full protocols MRI of each patient were separately interpreted by three neuroradiologists to assess disc herniation and nerve root compression. The consensus results of limited and full protocol were compared. The diagnostic performance of each protocol was analyzed using surgery as the gold standard. There were 62 females and 61 males enrolled into the study between the age of 21-60 years old (means = 42.91 years). The duration of pain was 1-204 months (mean = 31.20 months). The degree of severity was mild in 23.58%, moderate 45.52% and severe 30.89% of cases. Thirty-three cases were operated on. For detection ...
TURKISH JOURNAL OF MEDICAL SCIENCES, 2014
To carry out comparison and correlation analyses of the intervertebral disc (IVD) and vertebral body (VB) volumes in magnetic resonance (MR) images of patients with degenerated and nondegenerated lumbar discs. Materials and methods: MR images were examined retrospectively in 93 patients. Lumbar VB and IVD volumes in T1-T2 weighted sagittal MR images were calculated via the Cavalieri method, a stereological method. Volumetric changes in degenerated and nondegenerated discs were compared. Results: The percentages of degenerated IVDs were 12.9%, 12.9%, 28%, 50.5%, and 52% in discs from levels L1 to L5, respectively. There were no differences in VB volumes between the degenerated and nondegenerated groups for all lumbar vertebra levels. However, significant volumetric decreases were observed in degenerated IVDs for all lumbar vertebra levels, as compared to nondegenerated IVDs. Comparisons of VB volume and IVD volume ratios also revealed decreases, but they were significant only for levels L1 and L4. Conclusion: Disc volumes were found to be decreased, although vertebral bodies were not affected in degenerated IVD groups. However, using VB and IVD volume ratios may not always yield reliable results.
ASSOCIATION BETWEEN CLINICAL FEATURES AND MRI FEATURES IN PATIENTS WITH DISC PATHOLOGY
MRI is goldstandard for the diagnosis of lumbar disc pathology, but cost is out of reach for patients espacialy for labores, moreover MRI units are very limited in govement sector hospitals and patients have to wait for many days for MRI of spine with disabling pain. Objective of this study was to measure association between clinical features and MRI findngs in patients with lumbar disc prolapse. 50 patients with suspecting lumbar disc prolapse and sciatica were included in study. Index tests in clinical examination were bowstring test, nerve root compression sign of sensory and motor deficit and nerve root tension test (SLR). Reference test was MRI scane and evaluated by a radiologist. Descriptive statisticsabd chi square test was used to analyze data. Study was conducted on laborers, 8% were factory worker, 28% were construction worker and 60% were measons. 70 % patients shoewed positive MRI finding examined by radiologist. In clinical examination 72% patients showed positive bowstring test conducted by physiotherapist. Nerve root tension test was positive in 62 % participants. Nerve root compression sign of sensory and motor deficit was positive in 16 % patients. Pearsons chi square test between MRI finding and clinical finding were highly associated (pearson chi-square 10.884, 21.542 and 4.082 for bowstering test, nerve root tension test and nerve root compression sign of sensory and motor deficit respectively). MRI finding and clinical finding are associated in patients with disc prolapsed patients.
Morphometric Study of Lumbar Intervertebral Spaces (discs) by Using MRI
Journal of Lumbini Medical College, 2020
Introduction: The radiological space between two vertebrae is known as intervertebral space (height) which corresponds to the thickness of the intervertebral disc. Lumbar intervertebral disc is the most important structure which maintains the spinal function. An early diagnosis of pathological changes in disc has clinical significance. Hence the study aimed to determine normal height of the intervertebral disc space and effect of aging. Methods: It was a cross-sectional analytical study performed on 106 images of MRI scans of lumbar region. Dimensions of lumbar intervertebral spaces (discs) such as the anterior, middle, posterior intervertebral space height were measured in millimeter. Results: The mean anterior intervertebral space height was gradually increased from L1-L2 level (6.91 mm) to L5-S1 level (13.55 mm). The middle intervertebral space height increased from L1-L2 level (7.89 mm) to L4-L5 level (11.96 mm) whereas at L5-S1 level, there was a decrease (11.10 mm). Similarly,...
European Radiology, 2020
Objectives To investigate biomechanical changes in lumbar disc herniations. Methods Patients with lumbar disc herniation verified on a 1.5-3-T magnetic resonance imaging (MRI) scanner were imaged in a weight-bearing 0.25-T MRI scanner in (1) standing position, (2) conventional supine position with relative lumbar flexion, and (3) supine position with a forced lumbar extension by adding a lumbar pillow. The L2-S1 lordosis angle, the disc cross-sectional area, the disc cross-sectional diameter, and the spinal canal cross-sectional diameter were measured for each position. Disc degeneration and nerve root compression were graded, and the pain intensity was reported during each scan position. Results Forty-three herniated discs in 37 patients (36.7 ± 11.9 years) were analyzed in each position. The L2-S1 lumbar angle increased in the standing position (mean difference [MD]: 5.61°, 95% confidence interval [95% CI]: 3.44 to 7.78) and with the lumbar pillow in the supine position (MD: 14.63°, 95% CI: 11.71 to 17.57), both compared with the conventional supine position. The herniated disc cross-sectional area and diameter increased during standing compared with during conventional supine position. No changes were found in the spinal canal cross-sectional diameter between positions. Higher nerve root compression grades for paracentral herniations were found during standing compared with during conventional supine position. This was neither found with a lumbar pillow nor for central herniations in any position compared with conventional supine. Conclusion Disc herniations displayed dynamic behavior with morphological changes in the standing position, leading to higher nerve root compression grades for paracentral herniated discs. Key Points • Lumbar herniated discs increased in size in the axial plane during standing. • Increased nerve root compression grades for paracentral herniated discs were found during standing. • Weight-bearing MRI may increase the diagnostic sensitivity of nerve root compression in lumbar disc herniations.