Evaluation of the disco-vertebral junction using ultrashort time-to-echo magnetic resonance imaging: inter-reader agreement and association with vertebral endplate lesions
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To evaluate ultrashort time to echo (UTE) magnetic resonance (MR) morphology of the cartilaginous endplates (CEP) in cadaveric lumbar spines with bony vertebral endplate (VEP) lesions, to determine inter-reader agreement as well as associations between the CEP morphology and VEP lesions as well as other abnormalities.
Materials and methods
MR imaging of cadaveric lumbar spines from 10 donors was performed at 3T using a UTE MR sequence. Two musculoskeletal radiologists identified the location of vertebral endplate lesions in consensus. The morphology of the CEP overlying the lesions and in the adjacent normal regions was assessed individually. A total of 55 vertebral lesions and 55 normal regions were assessed. The presence of osteophytosis, morphological changes of the anterior and posterior longitudinal ligament, and intervertebral disc signal and morphology was also assessed. Agreement between observers was determined using Cohen’s kappa analysis, and association between CEP and vertebral endplate lesions was determined using the chi square test.
Fifty-five vertebral endplate lesions were identified and the morphology of CEP evaluated by two readers was in substantial agreement with Cohen’s kappa of 0.78. The presence of vertebral endplate abnormality was associated with the presence of osteophytes (39 out of 55 levels), altered morphology and signal of the anterior longitudinal ligament (23 out of 55 levels) and intervertebral discs (30 out of 55 levels).
UTE MRI enables evaluation of the CEP with substantial inter-reader agreement. Abnormal changes of the CEP may facilitate formation of lesions of vertebral endplate over time and are associated with degenerative changes of the lumbar spine.
KeywordsSchmorl’s node Disc degeneration Lumbar spine Osteophyte Back pain
Authors would like to thank Todd Griffith (LifeSharing, San Diego, CA) and Scott Barton (University of California, San Diego, Anatomic Services) for their assistance with cadaveric specimens.
Compliance with ethical standards
This article was made possible in part by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health in support of Dr. Won C. Bae (Grant Number R01 AR066622), and Award Number 5I01CX000625 (Project ID: 1161961) from the Clinical Science Research & Development of the VA Office of Research and Development in support of Dr. Christine B. Chung. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or Veterans Affairs.
Conflict of interest
The authors declare that they have no conflict of interest.
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