Study Of Intervertebral Disc Degeneration Based On IVIM And Texture Analysis

PART 1Value of intravoxel incoherent motion diffusion weighted imaging in quantitative diagnosis of lumbar disc degenerationObjective:To investigate the diagnostic value of quantitative parameters of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)in the degree of lumbar disc degeneration.Methods: From November 2021 to April 2022,450 lumbar discs of 90 patients who underwent lumbar MRI due to low back pain in Yijishan Hospital of Wannan Medical College were prospectively collected.The IVIM-DWI images were post-processed to obtain relevant parameters: apparent diffusion coefficient(ADC),slow diffusion coefficient(D),fast diffusion coefficient(D*)and perfusion fraction(f).ADC、D、D*and f values of nucleus pulposus,anterior and posterior annulus fibrosus from L1 to S1 were measured.ICC was used to evaluate the consistency of IVIM-DWI quantitative parameters measured by two physicians.One-way analysis of variance or Kruskal-Wallis H test was used to compare the differences of quantitative parameters between different Pfirrmann grades of intervertebral discs.Spearman rank correlation test was used to evaluate the correlation between Pfirrmann grade of lumbar disc degeneration and various quantitative parameters.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of statistically significant parameters for different Pfirrmann levels,and the area under the curve(AUC)was compared by De Long test.Results: Pfirrmann grading of lumbar disc degeneration was correlated with D values of nucleus pulposus,anterior annulus fibrosus and posterior annulus fibrosus(with correlation coefficients respectively-0.848,-0.386 and-0.408,P values all below0.001).Pfirrmann grading was correlated with ADC values of nucleus pulposus,anterior annulus fibrosus and posterior annulus fibrosus(with correlation coefficients respectively-0.85,-0.473,-0.571,P values all below 0.001).Pfirrmann grading was correlated with D* values of posterior annulus fibrosa(The correlation coefficient was-0.117,P < 0.05).Pfirrmann grade was correlated with the f values of nucleus pulposus and posterior annulus fibrosus(correlation coefficients were about 0.597 and0.119 respectively,P values below 0.05),and the other quantitative parameters were not correlated with Pfirrmann grade(P > 0.05).There were significant differences in D value of nucleus pulposus(P=0.016),ADC value of nucleus pulposus(P=0.044)and ADC value of anterior annulus fibrosus(P=0.019)between Pfirrmann grade Ⅰ and Ⅱ.The ADC value,D value,f value of nucleus pulposus,ADC value and D value of posterior annulus(all P < 0.001),D value and ADC value of anterior annulus(all P=0.001)were significantly different between grade Ⅱ and Ⅲ.The ADC value,D value and ADC value of anterior annulus(all P < 0.001),f value of nucleus pulposus and ADC value of posterior annulus(all P= 0.001),and D value of anterior annulus(P=0.005)were significantly different between grade Ⅲ and Ⅳ.The ADC value and D value of nucleus pulposus(all P < 0.001)and D value of posterior annulus fibrosus(P=0.008)were significantly different between grade Ⅳ and Ⅴ.Ordered Logisitc regression analysis of quantitative parameters with statistically significant differences between adjacent grades showed that ADC and D values of nucleus pulposus were statistically significant(P < 0.001).ROC curve analysis showed that ADC and D values of nucleus pulposus had higher diagnostic efficacy in different Pfirrmann grades.The AUC between Pfirrmann Ⅰ and Ⅱ was higher with D value than ADC value(Z=2.775,P=0.018).Conclusions:The quantitative parameters of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)are correlated with the Pfirrmann grade of lumbar intervertebral disc degeneration.The quantitative parameters of IVIM-DWI can be used to quantitatively evaluate the Pfirrmann grade of lumbar intervertebral disc degeneration,among which the D value of nucleus pulposus has good stability and high diagnostic efficiency,which is sensitive to the diagnosis of early intervertebral disc degeneration.PART 2The value of MR Texture features based on IVIM sequence in grading lumbar intervertebral disc degenerationObjective:To investigate the feasibility of MR Texture analysis based on IVIM sequence in evaluating the degree of lumbar intervertebral disc degeneration.At the same time,the correlation between texture feature parameters and Pfirrmann grading of lumbar disc degeneration was investigated.Methods:Patients who underwent lumbar MRI due to low back pain in Yijishan Hospital of Wannan Medical College from November 2021 to April 2022 were prospectively collected.A total of 450 lumbar intervertebral discs of 90 patients were included.ICC was used to evaluate the consistency of texture feature parameters extracted by the two physicians.Spearman rank correlation test was used to evaluate the correlation between Pfirrmann grading and texture features of lumbar disc degeneration.ROC curve was used to evaluate the diagnostic efficacy of texture feature parameters.Results:The Pfirrmann grade of lumbar disc degeneration was highly negatively correlated with Mean,Root Mean Squared,Energy,Maximum,Variance,Range,and High Gray Level Emphasis(correlation coefficients were respectively-0.728,-0.750,-0.707,-0.749,-0.737,-0.732),Pfirrmann grading of intervertebral disc degeneration was moderately correlated with Median and total energies(correlation coefficients were respectively-0.686,-0.663).The AUC values of Pfirrmann grade Ⅰ,Pfirrmann grade Ⅱ,Pfirrmann grade Ⅲ,Pfirrmann grade Ⅳ and Pfirrmann grade Ⅴ in the training set were 0.99,0.98,0.96,0.97 and 0.99,respectively.The AUC values of Pfirrmann grade Ⅰ,Pfirrmann grade Ⅱ,Pfirrmann grade Ⅲ,Pfirrmann grade Ⅳand Pfirrmann grade Ⅴ in the validation set were 0.87,0.86,0.77,0.83 and 0.83,respectively.The texture feature parameters showed good diagnostic performance in both the training set and the validation set.Conclusions:It is feasible to evaluate the degree of lumbar intervertebral disc degeneration based on IVIM sequence texture analysis parameters,and the texture parameters are correlated with Pfirrmann grade of lumbar intervertebral disc degeneration.