Ultrashort time-to-echo MRI of the cartilagenous endplate and relationship to degenerative disc disease and schmorl's nodes

Abstract

INTRODUCTION: The vertebral endplate is composed of an inner bony and outer cartilaginous endplates (CEP). The CEP supplies the intervertebral disc (IVD) with nutrients and metabolites, and is instrumental for metabolism, exchange of waste products and biomechanics of the disc 1. Lumbar disc degeneration on MRI is a risk factor for the development of low back pain 2. It has been previously hypothesized that changes in disc mechanics may be initiated by damage to the endplate 3, 4. Similarly, CEP defects may be involved in the formation of Schmorl’s nodes (SNs) (i.e. invagination of IVD material into the adjacent endplates) 5, which associated with severity of lumbar disc degeneration 6. The ultrashort time-to-echo (UTE) MRI is an imaging technique that enables improved visualization of tissues with short T2 relaxation that appear dark in signal on conventional T2-weighted (T2W) imaging. By employing this technique in the lumbar spine, we believe that the CEP, which appears hypointense in T2W MRI, may be observed as continuous high-signal and may thus be differentiated from the bony endplate. Although cadaveric studies have addressed the feasibility of UTE in assessing the CEP 7, studies addressing such technology in live human subjects …