A comparative study of diffusion kurtosis imaging and T2 mapping in quantitative detection of lumbar intervertebral disk degeneration

• Published in: European spine journal Vol. 28; no. 9; pp. 2169 - 2178
• Main Authors: Zeng, Feifei, Zha, Yunfei, Li, Liang, Xing, Dong, Gong, Wei, Hu, Lei, Fan, Yang
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2019; Springer Nature B.V
• Subjects: Anisotropy; Degeneration; Intervertebral discs; Kurtosis; Magnetic resonance imaging; Mapping; Medicine; Medicine & Public Health; Neurosurgery; Nucleus pulposus; Original Article; Surgical Orthopedics; Disk degeneration; Magnetic resonance imaging; T2 mapping; Diffusion kurtosis imaging
• ISSN: 0940-6719; 1432-0932; 1432-0932
• DOI: 10.1007/s00586-019-06007-z

Purpose To assess the feasibility of diffusion kurtosis imaging (DKI) for diagnosing lumbar intervertebral disk degeneration (IDD) and to compare the potential of DKI and T2* mapping in the diagnosis of early IDD. Methods Sagittal T2WI, DKI, and T2* mapping were performed in 75 subjects with 375 lumbar intervertebral disks at a 3.0-T MRI. DKI-related parameters including mean kurtosis (MK), mean diffusivity (MD), fractional anisotropy (FA), and T2* values were calculated for each disk which was segmented into three regions: nucleus pulposus (NP), anterior annulus fibrosus (AAF), and posterior annulus fibrosus (PAF). Results MK and FA were positively correlated with Pfirrmann grade (all P  < 0.001). MD and T2* were negatively correlated with Pfirrmann grade (all P  < 0.001) except for T2* value of AAF ( r  = 0.087, P  > 0.05). MK and FA values increased, while MD and T2* values decreased with age. No statistical significance was found between men and women ( P  > 0.05). Cephalic lumbar disks (L1/L2 and L2/L3) got lower MK and FA values than caudal lumbar disks (L4/L5 and L5/S1) (all P  < 0.05), while cephalic lumbar disks got higher MD value than caudal lumbar disks (all P  < 0.05). ROC analysis demonstrated that MK, MD, and FA showed significantly higher diagnostic accuracies than T2*, especially in NP and PAF. Conclusions DKI can be used to assess human lumbar IDD. And DKI was more sensitive to the quantitative detection of early lumbar IDD than T2* mapping. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.