Modic changes in vertebral endplates: a comparison of MR imaging and multislice CT

This paper aims to evaluate the presence of endplate sclerosis in different types of Modic changes and to assess the capability of MRI in detecting endplate sclerosis within these changes.

The lumbar spines (L3-S1) of 70 patients were retrospectively reviewed to determine Modic changes and disc degeneration from MRI and endplate sclerosis from CT. T1- and T2-weighted signal intensity and Hounsfield unit (HU) measurements of type I and II Modic changes were recorded and the association of both Modic types I and II with endplate sclerosis was analyzed with a Mann-Whitney test.

Altogether 82 Modic changes in 36 subjects were recorded: 13% were type I, 12% mixed type I/II, 65% type II, 9% mixed type II/III, and 1% type III. Thirty-eight percent of the endplates with Modic changes had sclerosis in CT. Of specific Modic types, mixed I/II and II/III associated significantly with endplate sclerosis. Endplate sclerosis was not detected in MRI in a quantitative analysis.

Endplate sclerosis exists in all types of Modic changes, especially in mixed Modic types, and not only in type III changes, as previously assumed. Endplate sclerosis was not detected in MRI, which may depend on the amount of mineralization of the bone marrow.