Associations between high intensity zones, endplate and Modic changes and their effect on T2‐mapping with and without spinal load

2021 ◽  
Author(s):  
K Lagerstrand ◽  
H Brisby ◽  
H Hebelka
Keyword(s):  
High Intensity ◽  
T2 Mapping ◽  
Modic Changes ◽  
Spinal Load

scholarly journals Associations between high intensity zones, Modic and endplate changes in lumbar spine of low back pain patients

2019 ◽  
Author(s):  
Kerstin Lagerstrand ◽  
Helena Brisby ◽  
Hanna Hebelka
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
High Intensity ◽  
T2 Mapping ◽  
Physiological Mechanism ◽  
Modic Changes ◽  
Morphological Features ◽  
Low Back ◽  
Endplate Changes ◽  
Tissue Characteristics

Abstract Background High intensity zones (HIZ), Modic and endplate changes have all been pointed out as potential markers of low back pain (LBP). If an association between these morphological features exist, it may not only deepen the understanding of the underlying patho-physiological mechanism of LBP but may also improve the diagnostics by enabling stratification between individuals with non-specific LBP as well as within individuals having multi-segmental changes. The aim was to investigate if HIZ, Modic and endplate changes are associated and if endplate and vertebral T2-values reflect functional tissue characteristics related to these morphological features.Methods 150 IVDs with corresponding endplates and vertebrae in 26 chronic LBP-patients (25-69y, mean 38y, 11 males) were examined with T1- and T2-weighted MRI, and T2-mapping. Associations between morphological features and between morphological features and functional T2-values were determined. Results HIZ (62% of patients, 1-2/patient) was associated with endplate changes (100% of patients, 1-7/patient) (p=0.0003 and 0.0004 for upper and lower endplates), with an occurrence of 91% for upper and 71% for lower endplates adjacent to discs with HIZ. Modic changes (81% of patients, 1-3/patient) was associated with endplate changes (p<0.0001) with an occurrence of 87% for endplates adjacent to vertebrae with Modic changes. The occurrence of both HIZ and Modic changes was 43% (p=0.0001) for upper and 29% (p=0.003) for lower vertebrae. Significantly higher T2-values (p<0.004) were found in the vertebral tissue with associated Modic changes and HIZ. Conclusions This study of LBP-patients suggests that HIZ is associated with simultaneous presence of both Modic and endplate changes in the same motion segment. If these three simultaneous morphological features are linked to an active inflammatory process, reflected as a clinical specific pain profile remains to be investigated.

scholarly journals Prevalence of High Intensity Zone in Lumbar Spine and its Correlation with Lumbar Disc Degeneration in Patients Attending Tertiary Hospital of Eastern Nepal

2021 ◽  
Vol 17 (1) ◽  
pp. 81-87
Author(s):  
Subash Chandra Jha ◽  
Satendra Raut ◽  
Pradip Kumar Gupta ◽  
Surya Parajuli
Keyword(s):  
Lumbar Spine ◽  
Disc Herniation ◽  
High Intensity ◽  
Lumbar Disc ◽  
Modic Changes ◽  
Leg Pain ◽  
Limited Information ◽  
Lumbar Disc Degeneration ◽  
Cross Sectional ◽  
High Intensity Zone

Introduction: A high intensity zone (HIZ) in intervertebral disc (IVD) of lumbar spine is a high intensity signal located in the annulus fibrosus of T2-weighted magnetic resonance (MR) imaging. There is limited information on the prevalence of HIZ in lumbar spine in Nepalese population. The aim of this cross-sectional study was to identify the prevalence of HIZ according to the age and its correlation with degenerated disc, disc herniation & bulge and modic changes. Methods: This was a prospective MR based study in 268 patients (1380 IVD) with LBP, Leg pain or numbness. The prevalence and correlation of HIZ , degenerated disc, disc herniation and bulge and modic change was evaluated in 5 age groups (<20, 20-39, 40-59, 60-79, >80). Results: The prevalence of HIZ in patients with LBP was 30.5%. Total 1340 IVD were examined out of which122 had HIZ, 742 had degenerated disc, 688 had disc herniation and bulge and 182 had modic changes. Degenerated disc was observed in 95% (116/122) and 51.3% (626/1218) of disc with and without HIZ respectively. Disc herniation and bulge were observed in 98.3% (120/122) and 46.6% (568/1218) of the disc with and without HIZ, respectively. Modic changes were observed in 11.4% (14/122) and 13.7% (168/1218) of disc with and without HIZ respectively. Conclusions: There was statistically significant correlation between existence of HIZ and degenerated discand disc herniation and bulge, but there was no correlation with the existence of modic changes.  

Association of Modic Changes, Schmorlʼs Nodes, Spondylolytic Defects, High-Intensity Zone Lesions, Disc Herniations, and Radial Tears With Low Back Symptom Severity Among Young Finnish Adults

Spine ◽  
2012 ◽  
Vol 37 (14) ◽  
pp. 1231-1239 ◽  
Author(s):  
Jani Takatalo ◽  
Jaro Karppinen ◽  
Jaakko Niinimäki ◽  
Simo Taimela ◽  
Pertti Mutanen ◽  
...  
Keyword(s):  
Symptom Severity ◽  
High Intensity ◽  
Modic Changes ◽  
Low Back ◽  
High Intensity Zone ◽  
Disc Herniations

Are high-intensity zones and Modic changes mutually exclusive in symptomatic lumbar degenerative discs?

2010 ◽  
Vol 12 (4) ◽  
pp. 351-356 ◽  
Author(s):  
Laurence A. G. Marshman ◽  
Andrew V. Metcalfe ◽  
Manoj Krishna ◽  
Tai Friesem
Keyword(s):  
High Intensity ◽  
Stable State ◽  
Modic Changes ◽  
Disc Height ◽  
Low Back ◽  
Imaging Studies ◽  
Demographic Differences ◽  
Lumbar Level ◽  
Larger Sample ◽  
Transitory State

Object Modic changes (MCs) and high-intensity zones (HIZs) potentially serve as variably sensitive markers for discogenic chronic low-back pain (CLBP). No study has hitherto assessed the phenomenon of MC-HIZ coexistence at a single level, and the goal in this study was to assess the nature and frequency of this phenomenon. Methods One hundred twenty consecutive patients with discogenic CLBP in whom lumbar MR imaging studies had demonstrated an HIZ, an MC, or both were included. Results This cohort (120 consecutive patients with 193 degenerative discs) had discogenic CLBP in at least 1 lumbar level associated with either an HIZ (77 discs), an MC (67 discs), or both (16 patients); there were 55 coexistent non-HIZ/non-MC degenerative discs. Painful MC-HIZ coexistence at 1 level occurred in 6 patients (5 of whom were female). If HIZs and MCs were random, independent entities, then MC-HIZ coexistence at 1 level would have been expected in 67 × 77/193 (that is, 27) discs. The observed frequency was therefore significantly lower (χ2 = 41, p < 0.001). There were no significant demographic differences between groups. The HIZ disc height (8 ± 0.2 mm) was significantly greater than the MC (6.6 ± 0.2 mm) or MC-HIZ (6.7 ± 0.2 mm) disc heights (p < 0.001). Conclusions In patients with discogenic CLBP associated with HIZ or MC lesions, MC-HIZ coexistence at 1 level was significantly rarer than expected even by chance; thus, despite both being manifestations of a seemingly common degenerative process, HIZ and MC more closely represent “either/or” phenomena. Because HIZ disc height was significantly greater, HIZs may develop earlier in the disc degenerative ontogeny. If any degenerative disc may only display an HIZ first, yet may ultimately display an MC instead, then HIZs must invariably regress as MCs supervene (or even vice versa). The MC-HIZ coexistence would therefore represent either a rare stable state (possibly more common in females) or a transitory state, as one lesion gradually replaces the other. Longitudinal studies would confirm or refute these hypotheses, although significantly larger sample sizes would be required.

scholarly journals Epidemiology of Lumbar Degenerative Phenotypes of Children and Adolescents: A Large-Scale Imaging Study

2021 ◽  
pp. 219256822110007
Author(s):  
Zhong-Yuan Wan ◽  
Jun Zhang ◽  
Hua Shan ◽  
Tang-Fen Liu ◽  
Fang Song ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Children And Adolescents ◽  
High Intensity ◽  
Large Scale ◽  
Lumbar Disc ◽  
Modic Changes ◽  
Lumbar Disc Degeneration ◽  
True Incidence ◽  
Significant Difference ◽  
Schmorl’S Nodes

Study Design: Cross-sectional study. Objective: Recently, there has been a rise in children and adolescents developing low back pain and/or sciatica. Degenerative lumbar spine MRI phenotypes can occur in this population but reports have been sporadic and the true incidence of such spine changes remains debatable. As such, the study aimed to address the epidemiology of MRI phenotypes of the lumbar spine in this young population. Methods: 597 children and adolescents with lumbar MRIs were included in the study. T1- and T2-weighted lumbar images from L1/2 to L5/S1 were analyzed in axial and sagittal planes. Global phenotype assessment was performed of each level and based on established nomenclature protocols. Results: The cohort consisted of 57.3% (342) boys and 42.7% (255) girls, with a mean age of 10.75 ± 5.25 years (range: 0 to 18 years). The prevalence of imaging findings of lumbar disc degeneration (LDD) and lumbar disc herniation (LDH) were 2.2% (95% CI: 0.93–3.43) and 5.8% (95%CI: 2.58-8.99), respectively. There was significant difference between each disc segment from L1/2 to L5/S1 for both LDD and LDH. Schmorl’s nodes were noted in 16 cases (2.7%, youngest case as 15 years), with 11 boys (68.8%) and most frequent segment as L3/4. Modic changes and high-intensity zones were absent in this cohort. Conclusions: LDD can emerge as early as the first decade of life with Schmorl’s nodes, without additional specific phenotypes, including Modic changes and high-intensity zones. The study provides valuable information of a unique age group that is often under-represented but equally important as adults.

A New High Intensity Grid Cap for RCA-EMU-3 Electron Microscopes

1968 ◽  
Vol 26 ◽  
pp. 316-317
Author(s):  
George Christov ◽  
Bolivar J. Lloyd
Keyword(s):  
Electron Beam ◽  
Electron Microscope ◽  
High Voltage ◽  
High Intensity ◽  
Electron Gun ◽  
Tungsten Filament ◽  
Fluorescent Screen ◽  
Electron Microscopes ◽  
Pass Through ◽  
Ground Potential

A new high intensity grid cap has been designed for the RCA-EMU-3 electron microscope. Various parameters of the new grid cap were investigated to determine its characteristics. The increase in illumination produced provides ease of focusing on the fluorescent screen at magnifications from 1500 to 50,000 times using an accelerating voltage of 50 KV.The EMU-3 type electron gun assembly consists of a V-shaped tungsten filament for a cathode with a thin metal threaded cathode shield and an anode with a central aperture to permit the beam to course the length of the column. The cathode shield is negatively biased at a potential of several hundred volts with respect to the filament. The electron beam is formed by electrons emitted from the tip of the filament which pass through an aperture of 0.1 inch diameter in the cap and then it is accelerated by the negative high voltage through a 0.625 inch diameter aperture in the anode which is at ground potential.

260: High Intensity Focused Ultrasound Combined with Endocrine Therapy in Treating High or Intermediate Risk Prostate Cancer

2006 ◽  
Vol 175 (4S) ◽  
pp. 86-86
Author(s):  
Makoto Sumitomo ◽  
Junichi Asakuma ◽  
Yasumasa Hanawa ◽  
Kazuhiko Nagakura ◽  
Masamichi Hayakawa
Keyword(s):  
Prostate Cancer ◽  
Endocrine Therapy ◽  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Intermediate Risk ◽  
Risk Prostate Cancer
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