3.0T MR Intravoxel Incoherent Motion Diffusion Weighted Imaging For Intervertebral Disc Degeneration

Objective:This study attempted to acquire lumbar spine MRI and IVIM-DWI imaging data using the magnetic resonance IVIM-DWI imaging technique on a 3.0T magnetic resonance imaging system platform.Explore the feasibility of applying IVIM-DWI imaging technology to lumbar disc scanning.Try to determine the normal range of ADC_slow,ADC_fast,and f values for the lumbar disc.Analyze the correlation between lumbar discs'ADC_fast,ADC_slow,f-value and Pfirrmann grading.Evaluate the value of IVIM-DWI imaging technology in quantitative diagnosis of lumbar disc degeneration,and provide a new method for quantitative evaluation of lumbar disc degeneration.Methods:In this study,98 volunteers?45 males and 53 females?were collected,aged 18-59 years,mean age?29.7�10.0?years old.All volunteers underwent conventional lumbar spine MRI scan and IVIM-DWI scan at 8-10 am.The intervertebral discs were graded according to the Pfirrmann grading standard.Data analysis using SPSS20.0 statistical oftware.One-way analysis of variance was used to compare the comparison between groups.The differences between different Pfirrmann grades and lumbar intervertebral disc ADC_fast,ADC_slow and f values were evaluated by variance analysis.The ROC curve was constructed and the area under the curve?AUC?was calculated.The maximum tangent point of the Youden index is the cut-off value?Cut-off value?,and the sensitivity and specificity corresponding to this point are obtained;the consistency analysis uses the intra-group correlation coefficient?ICC?.Results:1.The ADC_fast values of the L5-S1 intervertebral discs were statistically different from other anatomical level lumbar intervertebral discs There was no significant difference between other anatomical level lumbar intervertebral discs.The intervertebral disc f values in different anatomical level lumbar intervertebral discs were compared,except L4-5 intervertebral disc,the f value of the L5-S1 intervertebral disc was statistically different from other anatomical level lumbar intervertebral discs.2.In normal intervertebral discs,the reference range of ADC_fast value is 0.163-0.181 ?mm²/s?,the reference range of ADC_slow value is 0.00177-0.00245?mm²/s?,and the reference range of f value is 0.173-0.215.ADC_fast value can distinguish between Pfirrmann grade I and III intervertebral discs?AUC 0.744,Sensitivity 63.9%,Specificity 78.0%?,Grade I and IV intervertebral discs?AUC 0.815,Sensitivity 67.2%,Specificity 92.9%?,Grade II and III intervertebral discs?AUC 0.715,Sensitivity 56.7%,Specificity 78.0%?,Grade II and IV intervertebral discs?AUC 0.797,Sensitivity 60.8%,Specificity 92.9%?,and all of these have certain accuracy.ADC_slow value has certain accuracy in differentiating grade I and grade III intervertebral discs?AUC 0.707,Sensitivity 83.6%,Specificity 60.0%?.Grade I and IV discs were distinguished accurately?AUC=0.703,Sensitivity 83.6%,Specificity 57.1%?.The accuracy of differentiating grade II and III discs was low?AUC 0.670,Sensitivity 80.8%,Specificity 58.0%?.The accuracy of differentiating grade II and IV discs was low?AUC 0.671,Sensitivity 85.4%,Specificity 50.0%?.3.The ADC_fast,ADC_slow and f values of nucleus pulposus and anterior fibrous annulus were significantly different?P<0.001?;the ADC_fast,ADC_slow and f values of nucleus pulposus and posterior fibrous annulus were significantly different?P<0.001?;the ADC_fast,ADC_slow and f values of anterior and posterior fibrous annulus had no significant difference?P=0.731,0.084,0.942?.4.The consistency of ADC_fast,ADC_slow and f values measured by different observerswas good.5.The consistency of ADC_fast values of continuous scanning is statistically significan and general;the consistency of f values of any interval time has statistical significance and general consistency.Conclusion:1.IVIM-DWI imaging technology can be applied to lumbar intervertebral disc scanning,which is a potential method to evaluate the degeneration of lumbar intervertebral disc.However,the reference value of normal lumbar intervertebral discs still needs a large sample size support,and we will continue to collect more samples.2.IVIM-DWI imaging technology provides a new method and idea for the evaluation of lumbar intervertebral disc degeneration,and the consistency of measurements among different observers is good.3.The problem of the diagnostic efficiency of IVIM-DWI imaging in differentiating different degenerative processes of lumbar intervertebral disc is not high,which is drawn from the present study of this subject,we will continue to learn from the experience of other scholars,optimize parameters and standardize scanning,improve the repeatability of scanning,and then study the degeneration of lumbar intervertebral disc.