Multi-parameter evaluation of lumbar intervertebral disc degeneration using quantitative magnetic resonance imaging techniques

Objective: To quantitatively evaluate lumbar disc degeneration with recently-developed quantitative magnetic resonance imaging (MRI) techniques. A series of MRI parameters, including T2*, T1rho relaxation time, apparent diffusion coefficient and gagCEST, were compared and correlated with the Pfirrmann semi-quantitative classification of lumbar intervertebral disc degeneration; the most accurate and relevant MRI parameters of lumbar disc degeneration were identified. Materials and Methods: Thirty-seven subjects (age range, 18-74 years) with non-specific low back pain (LBP) for more than 6 months were enrolled. The L1/2-L5/S1 discs of each subject were measured and then analyzed. Results: The gagCEST value of the discs showed the best negative correlation with degeneration level (nucleus pulposus: r = -0.951, P < 0.001; annulus fibrosus: r = -0.938, P < 0.001). The discriminant analysis results showed that this parameter also had the highest correct rate using a single index (gagCEST discriminant accuracy = 82%). Conclusion: Early stage lumbar disc degeneration can be quantitatively evaluated with MRI using the chemical exchange saturation transfer technique.