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Ultrashort time-to-echo MR morphology of cartilaginous endplate correlates with disc degeneration in the lumbar spine

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Abstract

Purpose

Using ultrashort echo time (UTE) MRI, we determined prevalence of abnormal cartilaginous endplate (CEP), and the relationship between CEP and disc degeneration in human lumbar spines.

Materials and methods

Lumbar spines from 71 cadavers (age 14–74 years) were imaged at 3 T using sagittal UTE and spin echo T2 map sequences. On UTE images, CEP morphology was defined as “normal” with linear high signal intensity or “abnormal” with focal signal loss and/or irregularity. On spin echo images, disc grade and T2 values of the nucleus pulposus (NP) and annulus fibrosus (AF) were determined. 547 CEPs and 284 discs were analysed. Effects of age, sex, and level on CEP morphology, disc grade, and T2 values were determined. Effects of CEP abnormality on disc grade, T2 of NP, and T2 of AF were also determined.

Results

Overall prevalence of CEP abnormality was 33% and it tended to increase with older ages (p = 0.08) and at lower spinal levels of L5 than L2 or L3 (p = 0.001). Disc grades were higher and T2 values of the NP were lower in older spines (p < 0.001) and at lower disc level of L4-5 (p < 0.05). We found significant association between CEP and disc degeneration; discs adjacent to abnormal CEPs had high grades (p < 0.01) and lower T2 values of the NP (p < 0.05).

Conclusion

These results suggest that abnormal CEPs are frequently found, and it associates significantly with disc degeneration, suggesting an insight into pathoetiology of disc degeneration.

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Funding

The funding was provided by NIH NIAMS (AR066622, AR073761), RSNA Research and Education Foundation (RF1730), Swiss National Science Foundation (P2SKP3_16412), and Swiss Society of Radiology.

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Authors and Affiliations

  1. Department of Radiology, University of California, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA

    Tim Finkenstaedt, Palanan Siriwananrangsun, Graeme M. Bydder & Won C. Bae

  2. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Tim Finkenstaedt

  3. Department of Radiology, Siriraj Hospital, Bangkok, Thailand

    Palanan Siriwananrangsun

  4. Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA

    Koichi Masuda

  5. Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA

    Karen C. Chen & Won C. Bae

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  1. Tim Finkenstaedt
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  2. Palanan Siriwananrangsun
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Correspondence to Won C. Bae.

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Finkenstaedt, T., Siriwananrangsun, P., Masuda, K. et al. Ultrashort time-to-echo MR morphology of cartilaginous endplate correlates with disc degeneration in the lumbar spine. Eur Spine J 32, 2358–2367 (2023). https://doi.org/10.1007/s00586-023-07739-9

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  • DOI: https://doi.org/10.1007/s00586-023-07739-9

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