Functional Magnetic Resonance Imaging Of Lumbar Vertebral Bodies And Intervertebral Discs In Adolescent Scoliosis Patients

Chapter 1 The relationship of cervical curvature and T1 slope and disc degeneration in adolescent idiopathic scoliosis evaluated by MRIObjective To evaluate the relations of cervical curvature and T1 slope and disc degeneration in adolescent idiopathic scoliosis by MRI.Material and Methods A retrospective study of MRI image was done in 385 adolescent idiopathic scoliosis.The cervical curvature was divided into normal,straight and kyphosis.The T1 slope and cervical disc degeneration were measured.Results Among 385 cases of adolescent idiopathic scoliosis,90 cases with normal cervical curvature(23.4%)and the T1 slope was 28.1 � 3.8 �,205 cases with straight cervical curvature(53.2%)and the T1 slope was 16.6 � 5.5 �,and 90 cases with kyphosis(23.4%)and the T1 slope was 9.8 � 4.1 �.There was significant difference between normal and abnormal cervical curvature in the T1 slope(F = 331.8,p <0.01).There were significant correlations amon abnormal cervical curvature and the T1 slope and cervical disc degeneration.Conclusions There were significant relation of abnormal cervical curvature and the T1 slope and cervical disc degeneration.The T1 slope was lower and disc degeneration incidence was higher in patients with abnormal cervical curvature.Low T1 slope is a potential risk factor of cervical disc degeneration in adolescent idiopathic scoliosis.Chapter 2 Diffusion tensor imaging for evaluation of lumbar intervertebral disc in adolescent idiopathic scoliosis: a preliminary studyObjective To evaluate the degeneration of intervertebral disc(IVD)in adolescent idiopathic scoliosis(AIS)patients using diffusion tensor imaging(DTI).Materials and Methods Forty-three AIS patients and 12 healthy volunteers underwent 3 T MR scanning including DTI sequence.The mean diffusivity(MD)and fractional anisotropy(FA)values of lumbar IVDs were obtained and compared between healthy controls(HC)and AIS patients with two independent samples t test.Further analysis were done and focused on degenerative and non-degenerative discs and different lumbar segmental with two independent samples t test.Results The MD and FA values of IVDs in AIS patients differed significantly with healthy controls(MD: 1.25 � 0.17 vs 1.56 � 0.23 � 10-3 mm2/s,P < 0.001;FA: 0.31 � 0.06 vs 0.28 � 0.08,P = 0.014).The lowest MD(1.13 � 0.17 � 10-3 mm2/s,P = 0.001)and the highest FA values(0.33 � 0.05,P = 0.045)were obtained in degenerative IVDs compared with non-degenerative IVDs in AIS patients.The MD values of L4-5 IVDs were significantly higher than those of L1-3 IVDs in HC(P = 0.01),while,there was no significant difference of MD values between L1-3 and L4-5 IVDs in AIS patients.Conclusions DTI could serve as a sensitive modality to evaluate the degeneration of lumbar IVDs in patients with adolescent idiopathic scoliosis.There was a segmental pattern in disc degeneration and L4-5 IVDs were more prone to degenerate in patients with adolescent idiopathic scoliosis.Chapter 3 T1 rho imaging for evaluation of lumbar intervertebral disc in adolescent idiopathic scoliosis: a preliminary studyObjective To evaluate the degeneration of intervertebral disc(IVD)in adolescent idiopathic scoliosis(AIS)patients using T1 rho imaging.Materials and Methods Thirty-seven AIS patients and 20 healthy volunteers underwent 3 T MR scanning including T1 rho sequence.The T1 rho values of lumbar IVDs were obtained and compared between healthy controls(HC)and AIS patients with two independent samples t test.According to Pfirrmann grades of lumbar IVDs,AIS patients were categorized as group A(with all IVDs graded as Pm I)and group B(with some IVDs graded as Pm II or Pm III).Further analysis were done and focused on lumbar IVDs of different group and different lumbar segmental with two independent samples t test.Results The T1 rho values of IVDs in group B patients with AIS were significantly lower than those of group A patients(123.80�9.07 ms vs 129.31�2.83 ms,P <0.001).The T1 rho values of IVDs in both A and B group were significantly lower than those of healthy controls(129.31�2.83 ms vs 139.88�5.5ms,P <0.001;123.80�9.07 ms vs 139.88�5.5ms,P <0.001).The lowest T1 rho values(110.4�8.4ms,P <0.001)were obtained in IVDs with higher Pfirrmann grades.There was no significant difference of T1 rho values between L1-3 and L4-5 IVDs in HC.The T1 rho values of L5/S1 discs were significantly lower than those of L1-2 IVDs(P <0.05)in patients of group A.In patients of group B,the T1 rho values of L4-5 discs were significantly lower than those of L1-3 IVDs(P <0.05).Conclusions T1 rho could serve as a sensitive modality to evaluate the degeneration of lumbar IVDs in patients with adolescent idiopathic scoliosis.There was a segmental pattern in disc degeneration and L4-5 IVDs were more prone to degenerate in patients with adolescent idiopathic scoliosisChapter 4 Diffusion tensor imaging of lumbar vertebras in female adolescent idiopathic scoliosis: initial findingsObjective To characterize diffusion tensor imaging(DTI)features of lumbar vertebras in adolescent idiopathic scoliosis(AIS)patients.Materials and Methods Fifty-two AIS patients and 20 healthy volunteers underwent 3 T MR scanning including DTI sequence.The fractional anisotropy(FA)and apparent diffusion coefficient(ADC)values on the convex and concave sides of lumbar vertebras were obtained and compared.Results The FA and ADC values differed significantly between the convex and concave side of lumbar vertebras in AIS(P < 0.01).The ADC values in AIS differed significantly with healthy volunteers(P < 0.01).The FA values on the convex side of L1�2 were significantly lower than L4�5 in AIS.The difference of FA values between the concave and convex sides of the apex vertebra correlated significantly with Cobb angle(r = 0.436,P < 0.01).Conclusion The convex and concave sides of lumbar vertebras in AIS patients showed different DTI features.