Apparent Diffusion Coefficient of Diffusion-Weighted Imaging in Evaluation of Cervical Intervertebral Disc Degeneration: An Observational Study with 3.0 T Magnetic Resonance Imaging

Pinjie Chen, Chunlei Wu, Minghua Huang, Guangjian Jin, Qinglei Shi, Zhihua Han, Chun Chen, Pinjie Chen, Chunlei Wu, Minghua Huang, Guangjian Jin, Qinglei Shi, Zhihua Han, Chun Chen

Abstract

Aims: To investigate the correlation between the apparent diffusion coefficient (ADC) value and cervical intervertebral disc degeneration in adult symptomatic patients.

Methods: A total of 52 symptomatic and 40 healthy volunteers were included. DWI and routine MRI examinations were performed to their cervical spines. The cervical discs (from C2-C3 to C6-C7) were graded according to the Pfirrmann grading system, and ADC values of the nucleus pulposus (NP) were measured. Differences of the ADC values between different genders and anatomic levels were analyzed; the correlation between the ADC value and the Pfirrmann grade was investigated. The cut-off ADC values of each Pfirrmann grade were calculated.

Results: The mean ADC value of the NP decreased with increasing Pfirrmann grade (I-V) upon both patients and asymptotic volunteers. The ADC value decreased descendingly from C2-C3 to C5-C6 (P < 0.05) and then increased at C6-C7 (P < 0.05). Additionally, the comparison of the ADC values between different genders achieved statistical significance at each anatomical level (P < 0.05), except at C6-C7 (P > 0.05). Significant negative correlations between the ADC value and either age or Pfirrmann grade were observed.

Conclusions: Our preliminary findings suggest that the ADC value obtained by DWI can provide a reliable indicator to evaluate the cervical disc degeneration.

Figures

Figure 1
Figure 1
T2-WI, DWI, and ADC-colored map images of the cervical spine. (a) T2-WI image of the cervical spine, showing the anatomical information of the cervical spine and discs. (b) The diffusion-weighted image (DWI) of the cervical spine (b value = 0 and 500 s/mm2). (c) ADC-colored map of the cervical spine.
Figure 2
Figure 2
T2-WI and ADC-colored map of the cervical discs at each Pfirrmann grade and the ROI selection. According to the morphological shape of the disc on the T2-WI image, the ROI was manually delineated to cover the nucleus pulposus (NP) and then copied and pasted onto the ADC-colored map.
Figure 3
Figure 3
Negative correlation between the ADC value and the Pfirrmann grade. As shown in the graph, the ADC value decreased with higher Pfirrmann grade (r = −0.504, P < 0.001).

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