| Objective:The purpose of this study is to discuss the value of the ADC values on assessing lumbar disc degeneration, acute trauma and determine ADC values of normal range of lumbar disc.Materials and Methods:64 consecutive inpatients and outpatients at our hospital were given lumbar MRI examinations.Control group:30 healthy volunteers (male 13, female 17, age range 18-35 years, mean age 28 years) had no back pain, lower back trauma or surgery. Degeneration group:30 patients(male 20, female 10, age range 18-70 years, mean age 39 years) came to see doctor because of low back pain,20 patients reported having unilateral or bilateral lower limbs radiating pain,6 cases with lower limb weakness or othersymptoms of intermittent claudication. Trauma group:4 patients (male 1, female 3, age range 18-32 years, mean age 25 years) with acute trauma, that is, within 3 days after injury for MR examination. To simplify the sample parameters, we had to do a preliminary screening, excluding a small number of cases. Excluding the following criteria:1, obesity or excessive weight loss:we select body mass index (body mass index, BMI)±20% in the standard weight of the subjects to minimize the impact of body weight.2,below 18 years of age and above 70 years old subjects:This study used adults to minimize the impact of the age factor. All patients and volunteers in the study were voluntary and signed informed consent. By two radiologists independently evaluated on T2WI disc changes, including (1) disc height; (2) disc signal; (3) nucleus fracture. Where is the above-mentioned abnormal degeneration of a disc, and the remaining determined to be normal disc, and accordingly divided into the degenerative group and normal group. ADC map software Functool2 calculated in L1～S1 intervertebral disc was placed between the five regions of interest (region of interest, ROI) and measure the ADC values of each disc. ADC values of intervertebral disc volunteers associated with the anatomical location analysis, and degeneration group compared with the normal ADC values of intervertebral disc difference.Results:(1) 30 volunteers, ADC values and anatomical location was not obvious correlation,95% confidence interval of the normal intervertebral disc was 1.85×10-3～1.91×10-3mm2/s. (2) 30 patients with lumbar disc lesions displayed a rule: ADC values of near cephalad side were more than them near the end side in the lumbar vertebrae, L1/2 disc ADC value was more than L5/S1 disc. (3) mild and severe degeneration group had no significant difference between ADC values. (4) for the identification of acute lumbar intervertebral disc injury, followed up by DWI and ADC values we found high signal area on the DWI image displayed shrink trend, and ADC values showed decreasing trend generally.Conclusion:(1) the ADC values of normal disc have no correlation with the anatomical location, its normal range were (1.88±0.18)×10-3mm2/s. (2) the average ADC values of disc degeneration were (1.74±0.31)×10-3mm2/s, the variation is the closer near the cephalic end of the high side, in the L1 to S1 vertebrae, ADC value of L1/2 disc is more than L5/S1 disc. (3) for patients with acute lumbar intervertebral disc injury, follow-up DWI and ADC values are helpful to injury identification. |
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