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Classification of Intervertebral Disk Degeneration with Axial T2 Mapping

Atsuya Watanabe1,2,3, Lorin M. Benneker4, Chris Boesch1, Tomoko Watanabe5, Takayuki Obata6 and Suzanne E. Anderson2

1 Department of Clinical Research, Unit for MR Spectroscopy and Methodology, University of Bern, CH-3010 Bern, Switzerland.
2 Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, University of Bern, Bern, Switzerland.
3 Present address: Department of Radiology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba 299-0111, Japan.
4 Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
5 Tissue Engineering and Osteoarticular Research Unit, Institute of Pathology, University of Bern, Bern, Switzerland.
6 Department of Biophysics, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan.


Figure 1
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Fig. 1A Representative color-coded T2 maps. Color-coded T2 maps of intervertebral disks obtained with axial T2 mapping classification system show grade I in 23-year-old woman (A), grade II in 27-year-old man (B), grade III in 25-year-old man (C), and grade IV in 34-year-old man (D). Change of T2, loss of homogeneity in signal intensity, and loss of distinction between nucleus pulposus and annulus fibrosus were generally observed in degenerative intervertebral disks.

 

Figure 2
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Fig. 1B Representative color-coded T2 maps. Color-coded T2 maps of intervertebral disks obtained with axial T2 mapping classification system show grade I in 23-year-old woman (A), grade II in 27-year-old man (B), grade III in 25-year-old man (C), and grade IV in 34-year-old man (D). Change of T2, loss of homogeneity in signal intensity, and loss of distinction between nucleus pulposus and annulus fibrosus were generally observed in degenerative intervertebral disks.

 

Figure 3
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Fig. 1C Representative color-coded T2 maps. Color-coded T2 maps of intervertebral disks obtained with axial T2 mapping classification system show grade I in 23-year-old woman (A), grade II in 27-year-old man (B), grade III in 25-year-old man (C), and grade IV in 34-year-old man (D). Change of T2, loss of homogeneity in signal intensity, and loss of distinction between nucleus pulposus and annulus fibrosus were generally observed in degenerative intervertebral disks.

 

Figure 4
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Fig. 1D Representative color-coded T2 maps. Color-coded T2 maps of intervertebral disks obtained with axial T2 mapping classification system show grade I in 23-year-old woman (A), grade II in 27-year-old man (B), grade III in 25-year-old man (C), and grade IV in 34-year-old man (D). Change of T2, loss of homogeneity in signal intensity, and loss of distinction between nucleus pulposus and annulus fibrosus were generally observed in degenerative intervertebral disks.

 

Figure 5
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Fig. 2 Relationship between degenerative grades with axial T2 mapping and participant age. Degenerative grade increased with increasing age.

 

Figure 6
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Fig. 3 Relationship between degenerative grade with axial T2 mapping and disk level. Degenerative grade was highest at L5–S1 level, followed by grades at L4–L5 and L3–L4.

 

Figure 7
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Fig. 4 Relationship between T2 values of nucleus pulposus and participant age. T2 values decreased significantly with increasing age (p < 0.05).

 

Figure 8
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Fig. 5 Relationship between T2 values of annulus fibrosus and participant age. T2 values increased slightly with increasing age; however, correlation was not significant.

 

Figure 9
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Fig. 6 Relationship between T2 value of nucleus pulposus and degenerative grade classified with each of three classification systems. Bar indicates SD. Asterisk indicates p < 0.05.

 

Figure 10
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Fig. 7 Relationship between T2 value of annulus fibrosus and degenerative grade classified with each of three classification systems. Bar indicates SD. Asterisk indicates p <0.05.

 

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