Diffusion Properties of Asymptomatic Lumbar Intervertebral Discs in a Pediatric Cohort: a Preliminary Study of Apparent Diffusion Coefficient

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2022 Aug 8

PMID 35939067

Authors

Roxane Compagnon

Baptiste Brun-Cottan

Pauline Assemat

Julie Vial

Jerome Sales de Gauzy

Pascal Swider

Affiliations

Soon will be listed here.

Abstract

Purpose: To explore the apparent diffusion coefficients of intervertebral discs in an asymptomatic pediatric cohort.

Methods: We conducted a prospective MRI study of the lumbar spine from below the thoracolumbar junction to the lumbosacral junction on 12 subjects (mean age 13 y.o.) with no spinal pathology or spinal posture disorder. MRI was carried out using a 1.5 T machine with acquisitions realized both in sagittal and coronal planes. First, disc hydration was determined, and then, diffusion-weighted images were obtained using an SE single-shot echo-planar sequence. Apparent diffusion coefficients (ADC) of anterior annulus fibrosus (AAF), nucleus pulposus (NP) and posterior annulus fibrosus (PAF) were measured in the sagittal plane.

Results: Averaged hydration of 0.27 SD 0.03 confirmed the asymptomatic nature of discs. Average scaled values of ADC were 0.46 SD 0.01, 0.22 SD 0.09 and 0.18 SD 0.03 for NP, AAF and PAF, respectively. ADC of NP were almost constant along the spine; PAF values show a slight increase in the thorax-sacrum direction, while AAF values showed a pronounced decrease. Locally, ADC of AAF was higher compared to ADC PAF values below the thoracolumbar junction and it reversed for subjacent discs.

Conclusions: In our knowledge, our study provided the first diffusive properties of asymptomatic intervertebral discs in an adolescent cohort. ADC of NP was slightly higher than adults'. ADC evolutions of AAF were correlated with lordosis concavity which pointed out the role of compressive strain on fluid transport properties. This study could furnish information about segment homeostasis for exploration of pediatric spinal pathologies.

References

Urban J, Winlove C . Pathophysiology of the intervertebral disc and the challenges for MRI. J Magn Reson Imaging. 2007; 25(2):419-32. DOI: 10.1002/jmri.20874. View

Ludescher B, Effelsberg J, Martirosian P, Steidle G, Markert B, Claussen C . T2- and diffusion-maps reveal diurnal changes of intervertebral disc composition: an in vivo MRI study at 1.5 Tesla. J Magn Reson Imaging. 2008; 28(1):252-7. DOI: 10.1002/jmri.21390. View

Pfirrmann C, Metzdorf A, Zanetti M, Hodler J, Boos N . Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001; 26(17):1873-8. DOI: 10.1097/00007632-200109010-00011. View

Botchu R, Bharath A, Davies A, Butt S, James S . Current concept in upright spinal MRI. Eur Spine J. 2017; 27(5):987-993. DOI: 10.1007/s00586-017-5304-3. View

Le Bihan D . Apparent diffusion coefficient and beyond: what diffusion MR imaging can tell us about tissue structure. Radiology. 2013; 268(2):318-22. DOI: 10.1148/radiol.13130420. View

Wu N, Liu H, Chen J, Zhao L, Zuo W, Ming Y . Comparison of apparent diffusion coefficient and T2 relaxation time variation patterns in assessment of age and disc level related intervertebral disc changes. PLoS One. 2013; 8(7):e69052. PMC: 3724871. DOI: 10.1371/journal.pone.0069052. View

Zhang W, Ma X, Wang Y, Zhao J, Zhang X, Gao Y . Assessment of apparent diffusion coefficient in lumbar intervertebral disc degeneration. Eur Spine J. 2014; 23(9):1830-6. DOI: 10.1007/s00586-014-3285-z. View

Kealey S, Aho T, DeLong D, Barboriak D, Provenzale J, Eastwood J . Assessment of apparent diffusion coefficient in normal and degenerated intervertebral lumbar disks: initial experience. Radiology. 2005; 235(2):569-74. DOI: 10.1148/radiol.2352040437. View

10.

Niu G, Yu X, Yang J, Wang R, Zhang S, Guo Y . Apparent diffusion coefficient in normal and abnormal pattern of intervertebral lumbar discs: initial experience. J Biomed Res. 2013; 25(3):197-203. PMC: 3597053. DOI: 10.1016/S1674-8301(11)60026-2. View

11.

Antoniou J, Demers C, Beaudoin G, Goswami T, Mwale F, Aebi M . Apparent diffusion coefficient of intervertebral discs related to matrix composition and integrity. Magn Reson Imaging. 2004; 22(7):963-72. DOI: 10.1016/j.mri.2004.02.011. View

12.

Tokuda O, Okada M, Fujita T, Matsunaga N . Correlation between diffusion in lumbar intervertebral disks and lumbar artery status: evaluation with fresh blood imaging technique. J Magn Reson Imaging. 2006; 25(1):185-91. DOI: 10.1002/jmri.20785. View

13.

Jarman J, Arpinar V, Baruah D, Klein A, Maiman D, Tugan Muftuler L . Intervertebral disc height loss demonstrates the threshold of major pathological changes during degeneration. Eur Spine J. 2014; 24(9):1944-50. DOI: 10.1007/s00586-014-3564-8. View

14.

Yu H, Bahri S, Gardner V, Tugan Muftuler L . In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework. Eur Spine J. 2014; 24(11):2442-8. DOI: 10.1007/s00586-014-3721-0. View

15.

Kerttula L, Jauhiainen J, Tervonen O, Suramo I, Koivula A, Oikarinen J . Apparent diffusion coefficient in thoracolumbar intervertebral discs of healthy young volunteers. J Magn Reson Imaging. 2000; 12(2):255-60. DOI: 10.1002/1522-2586(200008)12:2<255::aid-jmri7>3.0.co;2-t. View

16.

Wong A, Parent E, Dhillon S, Prasad N, Samartzis D, Kawchuk G . Differential patient responses to spinal manipulative therapy and their relation to spinal degeneration and post-treatment changes in disc diffusion. Eur Spine J. 2019; 28(2):259-269. DOI: 10.1007/s00586-018-5851-2. View

17.

Krueger E, PERRY J, Wu Y, Haughton V . Changes in T2 relaxation times associated with maturation of the human intervertebral disk. AJNR Am J Neuroradiol. 2007; 28(7):1237-41. PMC: 7977630. DOI: 10.3174/ajnr.A0546. View

18.

Bolzinger M, Estivalezes E, Gallini A, Polirsztok E, Abelin-Genevois K, Baunin C . MRI evaluation of the hydration status of non-pathological lumbar intervertebral discs in a pediatric population. Orthop Traumatol Surg Res. 2020; 106(7):1281-1285. DOI: 10.1016/j.otsr.2019.11.034. View

19.

Abelin-Genevois K, Estivalezes E, Briot J, Sevely A, Sales de Gauzy J, Swider P . Spino-pelvic alignment influences disc hydration properties after AIS surgery: a prospective MRI-based study. Eur Spine J. 2015; 24(6):1183-90. DOI: 10.1007/s00586-015-3875-4. View

20.

Brun-Cottan B, Assemat P, Doyeux V, Accadbled F, Sales de Gauzy J, Compagnon R . An energy approach describes spine equilibrium in adolescent idiopathic scoliosis. Biomech Model Mechanobiol. 2020; 20(1):359-370. DOI: 10.1007/s10237-020-01390-9. View