Asian Spine J.  2022 Apr;16(2):254-260. 10.31616/asj.2020.0648.

Quantifying Bone Marrow Edema Adjacent to the Lumbar Vertebral Endplate on Magnetic Resonance Imaging: A Cross-Sectional Study of Patients with Degenerative Lumbar Disease

Affiliations
  • 1Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
  • 2Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan
  • 3Department of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan

Abstract

Study Design: Cross-sectional study. Purpose: We aimed to quantitatively assess bone marrow edema (BME) on magnetic resonance imaging (MRI) for patients with degenerative lumbar diseases. Overview of Literature: BME adjacent to a sclerotic endplate of the lumbar spine, detected using T2-weighted fat-saturated MRI, is closely associated with low back pain in patients with degenerative lumbar diseases. However, currently, there no quantitative evaluation methods for BME adjacent to the vertebral endplate.
Methods
Patients with degenerative lumbar diseases, whose MRIs detected BME, were enrolled. On a T2-weighted fat-saturated MRI, BME appeared as a high-intensity region adjacent to the vertebral endplate. We calculated the contrast ratios (CRs) of BME and normal bone marrow using the signal intensities of BME, normal bone marrow, and the spinal cord. On computed tomography, we calculated Hounsfield unit (HU) values in the same area as BME, the sclerotic endplate, and normal bone marrow to assess bone density.
Results
There were 16 men and 14 women, with an average age of 73.5 years. The mean CRs of BME and normal bone marrow were −0.015±0.056 and −0.407±0.023, respectively. BME’s CR was significantly higher than that of normal bone marrow (p<0.01). The HU values in the same area as BME, the sclerotic endplate, and normal bone marrow were 251.9±24.6, 828.3±35.6, and 98.1±9.3, respectively; these values were significantly different from each other (p<0.01).
Conclusions
The CR on MRI is a useful quantitative assessment tool for BME in patients with degenerative lumbar diseases.

Keyword

Bone marrow edema; Endplate lesion; Contrast ratio; Low back pain
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