Abstract
Purpose
To evaluate the role of apparent diffusion coefficient (ADC) as a quantitative means to assess the degree of intervertebral disc (IVD) degeneration contextually within the framework of a widely used Pfirrmann classification rather than in a direct correlation with Pfirrmann grades.
Methods
DWI and T2-weighted (T2w) of lumbar spine were acquired from nine healthy volunteers (age range 27–62 years, mean age 45 years) with a 3T MR scanner. ADC values were obtained from each of the five lumbar discs via a pixel-by-pixel ADC calculation as well as via region of interest-averaged image intensities. Disc degeneration was assessed by a scoring system via sequential application of Pfirrmann scale and use of intensity ratio of IVD/cerebrospinal fluid in T2w for discs in each Pfirrmann grade to be further separated.
Results
A significant correlation was observed between degenerative scores and ADC independent of how ADC was obtained (Spearman’s ρ < −0.85, P < 2 × 10−14).
Conclusions
This study demonstrates that previously perceived as an overlap in ADC value existing between different degenerative categories based on a visual inspection can be viewed as a quantitative role of ADC in assessment of disc degeneration. This reinforces the Pfirrmann classification system but also proceeds beyond mere qualitatively determining morphologic states.
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Conflict of interest
Funding support in part by CardioVascular BioTherapeutics (CVBT), Inc. Vance Gardner is a former consultant of CVBT. For the remaining authors no conflicts of interest were declared.
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Yu, H.J., Bahri, S., Gardner, V. et al. In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework. Eur Spine J 24, 2442–2448 (2015). https://doi.org/10.1007/s00586-014-3721-0
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DOI: https://doi.org/10.1007/s00586-014-3721-0