However, this scoring system is subjective, and it is unable to evaluate early biochemical changes of IVDD. The Pfirrmann semi-quantitative classification is the most widely used for visual grading of IVDD, which is focused on the signal intensity and homogeneity of NP, distinction of the NP and AF, and height of the disc on sagittal T2-weighted images. MRI is an important tool for evaluating IVDD. In this context, noninvasive imaging modalities are required for the detection of early changes and the severity of IVDD. Surprisingly, recent studies showed regenerative strategies such as biologic and cell therapies may be applied for early-stage IVDD to limit disease progression. Unfortunately, current surgical treatments such as spinal fusion and replacement of disc are limited to pain relief treatment for severe IVDD. ![]() ![]() The later stages of IVDD are manifested in morphological changes, including disc bulging or herniation, annulus fibrosus (AF) tears, and vertebral osteophytes. Early phase of IVDD presents with biochemical changes, including decreases of overall proteoglycan and water content in the nucleus pulposus (NP). Intervertebral disk degeneration (IVDD) is considered to be one of the primary causes of low back pain. Low back pain affects up to 40%–80% of the population at some point during their lifetime, with considerable negative impacts on quality of life and social economy. T1ρ and T2 mapping performed similarly but better than T2* mapping for advanced degeneration and morphologic changes of IVDD. T2 mapping performed better than T1ρ mapping for the detection of early IVDD. The AUC of T2 relaxation time was significantly higher than those of T1ρ relaxation times (both P 0.05) but significantly higher than that of T2*relaxation time ( P < 0.01). AUCs of T1ρ, T2 and T2* relaxation times of NP were 0.78, 0.83 and 0.64 for bulging discs, 0.87, 0.89 and 0.69 for herniated discs, and 0.79, 0.82 and 0.69 for annular tearing, respectively. Areas under the curves (AUCs) of T1ρ, T2 and T2* relaxation times of NP were 0.70, 0.87 and 0.80 for early degeneration, and 0.91, 0.95 and 0.82 for advanced degeneration, respectively. T2 relaxation times was strongly corelated with T1ρ and T2* relaxation times. The performances of T1ρ, T2 and T2* relaxation times were compared for detecting early (Pfirrmann grade II-III) and advanced degeneration (Pfirrmann grade IV–V), as well as for morphologic changes. IVDD was assessed with Pfirrmann grading and morphologic changes (normal, bulging, herniation and annular fissure). T1ρ, T2 and T2* mapping were performed, and T1ρ, T2 and T2* values of nucleus pulposus (NP), and anterior and posterior annulus fibrosus were measured. This prospective study included 39 subjects with 195 lumbar discs. This study aims to correlate and compare the performances of T1ρ, T2 and T2* mapping for Pfirrmann grades and morphologic changes in the IVDD. ![]() Early and accurate assessment of lumbar intervertebral disc degeneration (IVDD) is very important to therapeutic strategy.
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