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Longitudinal study of high intensity zones on MR of lumbar intervertebral discs

D Mitra1, V N Cassar-Pullicino, I W McCall

  • 1Department of Neuroradiology, Newcastle General Hospital, Newcastle-upon-Tyne, UK. dipayan.mitra@nuth.northy.nhs.uk

Clinical Radiology
|October 19, 2004
PubMed
Abstract

Insights

High intensity zones (HIZs) on lumbar spine MRIs often resolve or improve spontaneously. Study findings indicate no significant correlation between HIZ changes and patient symptom evolution, suggesting HIZs may not be a direct indicator of pain changes.

Area of Science:

  • Radiology
  • Spinal Imaging
  • Degenerative Disc Disease

Background:

  • High intensity zones (HIZs) are observed on MRI in degenerative lumbar spine disease.
  • The clinical significance and temporal evolution of HIZs remain areas of investigation.

Purpose of the Study:

  • To investigate the natural history of HIZs on lumbar spine MRI.
  • To determine if changes in HIZs correlate with changes in patient-reported symptoms.

Main Methods:

  • MRI scans of 56 patients with degenerative lumbar spine disease were analyzed.
  • Initial and follow-up scans assessed HIZ changes; patient symptoms were evaluated using VAS and Oswestry scores.
  • Confounding factors were identified and analyzed separately.

Main Results:

  • HIZs resolved in 26.6%, improved in 14%, worsened in 18.8%, and remained unchanged in 40.6% of lumbar disc levels.
  • No statistically significant correlation was found between HIZ evolution and subjective symptom changes (p=0.26).
  • Similar lack of correlation was observed with VAS and Oswestry Questionnaire Scores.

Conclusions:

  • HIZs demonstrate a tendency to spontaneously resolve or improve in a significant proportion of patients.
  • MRI-detected HIZ changes do not show a statistically significant correlation with alterations in patient-reported symptoms.

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