Quantitative Analysis of Magnetic Resonance Image Sagittal T2 Mapping in Lumbar Spine Classification

Objective: To evaluate the significance of T2 value changes of nucleus pulposus and annulus fibrosus in intervertebral disc degeneration, and to discuss feasibility and effectivity of intervertebral disc classification through MRI sagittal T2 mapping (specifically based on sagittal multi-echo SE sequence T2 mapping). Methods : 35 healthy volunteers (including 20 males and 15 females, aged 20 to 48, average age is 36.8) were randomly selected and their intervertebral discs of L3/L4, L4/L5 and L5/S1, with a sum-up of 90 discs, were scanned by sagittal MRI using routine FSE sequence as well as multi-echo SE sequence. T2 mapping was handled by image post-processing and each intervertebral disc was classified. T2 values of nucleus pulposus and annulus fibrosus were measured and statistical analysis were performed to study the relationship between T2 values and ages, disc grades or disc locations. Results: In classification through MRI sagittal T2 mapping, the disc grade increased along with the decrease of disc location or the increase of age. T2 value of nucleus pulposus decreased along with the increase of age (P < 0.05). There was a significant difference in T2 mean values of nucleus pulposus of different grades (P < 0.05). Conclusion: MRI sagittal T2 mapping provides us with a classification of intervertebral disc based on T2 values. Through evaluation of T2 mapping and measurement of T2 values of nucleus pulposus and annulus fibrosus, early stage degeneration of intervertebral disc can be monitored and the its relationship with relevant factors can be studied.

3D Morphology Analysis of TMJ Articular Eminence in Magnetic Resonance Imaging

Purpose. The objective of this study was to evaluate the computational reconstruction of the articular eminence of the temporomandibular joint (TMJ) based on magnetic resonance imaging (MRI) and semiautomatic volumetric segmentation techniques for morphological classification of the TMJ structure. Materials and Methods. A total of 36 MRI scans of TMJ individuals were selected and formatted by using the ITK-SNAP software, consisting of MRI segmentation and generation of 3D models. The TMJ articular eminences were also classified according to the morphology analysis of the articular eminence in 3D reconstructions. Two independent trained and calibrated investigators performed the image analysis, which was repeated after thirty days. Results. There was no association between sex and eminence shape (p=0.456). Fisher’s test revealed no statistically significant association between disc classification and eminence shape on both sides (p=0.629). Chi-square test showed a significant statistically association between disc classification and disc displacement (p=0.000). Intra- and interrater correlation coefficients showed excellent reproducibility values. Conclusions. Anatomical variability of the sample investigated was found, with predominantly round shape and presence of correlation between this shape and normal disc position. The correlation of flattened and convex shapes with disc position reduction indicated that type of disc derangement is more prevalent.

CLINICAL-RADIOGRAPHIC CORRELATION OF DEGENERATIVE CHANGES OF THE SPINE - SYSTEMATIC REVIEW

ABSTRACT Systematic review of the literature on the evaluation of images of degenerative changes of the spine and its clinical correlation. A systematic literature review was conducted, and the results evaluated for the presence of clinical correlation, as well as the type of imaging method used. The search terms were "Intervertebral Disc Degeneration", "Intervertebral disc", "Classification", "Anulus fibrosus", "Nucleus pulposus", "Lumbar spine", "Degenerative disc disease", "Degeneration", "Zygapophyseal Joint". We also assessed whether there were inter- and intraobserver agreement in the selected works and possible guidelines regarding the treatment and prognosis of patients. Of the 91 reviewed abstracts, 31 articles were selected that met the inclusion criteria. Six articles were related to the cervical spine, 13 to the lumbar spine and 12 were about changes not related specifically to a single segment of the spine. Articles that determined limiting values considered normal were also included, since variations were considered signs of degeneration or pathology. It was not possible to establish the relationship between the changes identified in imaging and the clinical history of patients, either define treatment and prognosis guidelines.