The Study Of Magnetic Resonance Diffusion Tensor Imaging In Quantitative Analysis Of Lumbar Degeneration And Radiculopathy

Part I: The study of magnetic resonance diffusion tensor imagingparameter values of the degenerated intervertebral disks basedon Pfirrmann gradingObjective: To quantitatively assess magnetic resonance diffusion tensorimaging parameter values of the degenerated intervertebral disks based onPfirrmann grading.Methods:52patients and20healthy volunteers were imaged at3.0TMRI for T1, T2and DTI scan. DTI images of intervertebral disks and thecalculation of T2values, ADC values and FA values were made by MRIworkstation. The analysis of the relationship between T2values and ADCvalues, between T2values and FA values was made by SAS9.0software.According to T2WI of disks, the disks were divided into five groups, and thedifferences of T2values, ADC values and FA values of these groups wereanalyzed. If the p value was less than0.05, the result would be statisticsignificance.Results:1The grading of disks. The generated disks were divided into2to5grades according to Pfirrmann grading system. The healthy disks were calledgrade1according to Pfirrmann grading system.2Of healthy disks, the T2values had positive relationship with ADCvalues and negative relationship with FA values. The correlation index wasstatistic significance.3The relationship between T2values and ADC values, between T2values and FA values of degenerated disks. In grade2disks, the T2valueshave positive relationship with ADC values, but did not had relationship withFA values. In disks of grade3, the relationship between T2values and ADC values, and the relationship between T2values and FA values showed nostatistical significance. In disks of grade4and grade5, T2values had positiverelationship with ADC values and negative relationship with FA values. Thecorrelation index was statistic significance.4The correlation between disks Pfirrmann grading system and T2values,ADC values and FA values. Pfirrmann grading system had statisticallycorrelation with T2values, ADC values and FA values, and the p value wasless than0.0001, respectively.5Comparison of T2values, ADC values and FA values to each group.The differences between grade1and others of T2values, ADC values and FAvalues showed statistical significance. The differences between grade2andothers of T2values and ADC values showed statistical significance. Thedifferences of FA values between grade2and grade1,4,5showed statisticalsignificance. were not different. The FA values between grade2and grade3were not different. The differences of T2values between grade3and grade1,2,5showed statistical significance; the differences of ADC values betweengrade3and grade1,2showed statistical significance; the differences of FAvalues between grade3and grade1,5showed statistical significance. Thedifferences of T2values, ADC values and FA values between grade4andgrade1,2showed statistical significance. The differences of T2valuesbetween grade5and grade1,2,3showed statistical significance; thedifferences of ADC values between grade5and grade1,2showed statisticalsignificance; the differences of FA values between grade5and grade1,2,3showed statistical significance.Conclusions:1In nucleus pulposus of normal intervertebral disks, T2values hadpositive relationship with ADC values and negative relationship with FAvalues. It indicated that in normal situation, nucleus pulposus was rich in water,and the molecule diffusion was free so the anisotropic character was notobvious.2The more serious the disk degenerated, the lower T2values and ADC values were and the higher FA values, which implied that the degeneratednucleus pulposus was lack of water and molecule diffusion movement wasrestricted.3In degenerated disks, the changes of T2values were in accordance withthe ADC values, so the ADC value could be an indicator to assess the situationof disks.4In slight to moderate degenerated disks, the changes of ADC valueswere not in accordance with the FA values, which implied that the disks werein the state of transition and the degeneration process could be reversed bytreatment.Part Ⅱ: The study of magnetic resonance diffusion tensor imaging toassess the role of the waist muscle groups in disk degeneratedprocessObjective:To evaluate the role of the waist muscle group in diskdegenerated process by quantitative analysis of FA values and ADC values.Methods:52patients and20healthy volunteers were imaged at3.0TMRI for T1, T2and DTI scan. The healthy volunteers were divided into twogroups: younger (age under18years old) and adult. According to T2WI ofdisks, the degenerated disks were divided into4groups,2to5grades. Thecalculation of ADC values and FA values of the waist muscle groups weremade by MRI workstation. The analysis of the differences of bilateral muscleADC values and FA values was made by SAS9.0software.Results:1In healthy volunteers, the FA values and ADC values of bilateral psoasmajor in the younger group were not different, and the FA values of bilateralerector spinae were not different but the ADC values were different. In theolder group the FA values and ADC values of bilateral psoas major weredifferent, and the FA values of bilateral erector spinae were not different butthe ADC values were different.2The comparsion of FA values and ADC values of bilateral psoas majorand erector spinae. On the level of grade2to5disks, the FA values and ADC values of bilateral psoas major were both different, while the FA values ofbilateral erector spinae were not different. Except for grade3and5, on thelevel of grade2and4disks, the difference of bilateral erector spinae ADCvalues was not statistically significant.3In younger group, the shapes of muscle tensors were natural and glossy,while in older group and degenerated groups the shapes of muscle tensorswere disordered, gathered.Conclusions:1DTI could noninvasively assess the muscle function quantitatively andprovided more information about muscle damage.2DTI could give useful information to evaluate the relationship betweenlumbar unstability and intervertebral disk degeneration.Part Ⅲ:The phasic research of magnetic resonance diffusion tenorimaging to quantitativelly evaluate radiculopathyObjective:To quantitatively evaluate the radiculopathy caused bydegenerating disks by means of magnetic resonance diffusion tractography.Methods:18patients with radiculopathy caused by degenerating diskswere imaged at3.0T MRI for T1, T2and DTI scan. The diffusion tractographywere performed by volumn one software. Then quantitatively the number, areaand shape of fiber tracts were quantitatively analysed. The charateristics ofbilateral fiber tracts were compared.Results: The number of the affected and the unaffected side was notdifferent, while the area and the shape were significantly different. The area ofthe affected side was less than the unaffected side. The compressed nerve rootswere gathering, imperfect and no branch, the unaffected side were opposite.Conclusions:1It’s the first that the magnetic resonance diffusion tractography hasbeen used to evaluate the function of nerve root, further more, it could guidethe treatment and to predict the prognosis.2By comparing the affected side and the unaffected side, it was knownthat the displayed number of fiber tracts did not have clinical meaning, but the area and the shape of fiber tract were the important reminder in radiculopathy.3The affected nerve roots showed gathered and incomplete shape and nobranch, while the unaffected nerve roots were opposite. That was inaccordance with the anatomy.