Is the Transport of a Gadolinium-Based Contrast Agent Decreased in a Degenerated or Aged Disc? A Post Contrast MRI Study

Marta Tibiletti, Fabio Galbusera, Cristina Ciavarro, Marco Brayda-Bruno

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

A post contrast magnetic resonance imaging study has been performed in a wide population of low back pain patients to investigate which radiological and phenotypic characteristics influence the penetration of the contrast agent in lumbar discs in vivo. 37 patients affected by different pathologies (disc herniation, spondylolisthesis, foraminal stenosis, central canal stenosis) were enrolled in the study. The selected population included 26 male and 11 female subjects, with a mean age of 42.4±9.3 years (range 18-60). Magnetic resonance images of the lumbar spine were obtained with a 1.5 T scanner (Avanto, Siemens, Erlangen, Germany) with a phased-array back coil. A paramagnetic non-ionic contrast agent was injected with a dose of 0.4 ml/kg. T1-weighted magnetic resonance images were subsequently acquired at 5 time points, 5 and 10 minutes, 2, 4 and 6 hours after injection. Endplates presented clear enhancement already 5 minutes after injection, and showed an increase in the next 2 hours followed by a decrease. At 5 and 10 minutes, virtually no contrast medium was present inside the intervertebral disc; afterwards, enhancement significantly increased. Highly degenerated discs showed higher enhancement in comparison with low and medium degenerated discs. Discs classified as Pfirrmann 5 showed a statistically significant higher enhancement than Pfirrmann 1, 2 and 3 at all time points but the first one, possibly due to vascularization. Disc height collapse and Modic changes significantly increased enhancement. Presence of endplate defects did not show any significant influence on post contrast enhancement, but the lack of a clear classification of endplate defects as seen on magnetic resonance scans may be shadowing some effects. In conclusion, disc height, high level of degeneration and presence of Modic changes are factors which increase post contrast enhancement in the intervertebral disc. The effect of age could not be demonstrated.

Original languageEnglish
Article numbere76697
JournalPLoS One
Volume8
Issue number10
DOIs
Publication statusPublished - Oct 11 2013

Fingerprint

gadolinium
intervertebral disks
Gadolinium
Magnetic resonance
Magnetic resonance imaging
Contrast Media
Magnetic Resonance Spectroscopy
Intervertebral Disc
injection
lumbar spine
back (body region)
scanners
Pathologic Constriction
magnetic resonance imaging
Spondylolisthesis
pain
Injections
Germany
Low Back Pain
Defects

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Is the Transport of a Gadolinium-Based Contrast Agent Decreased in a Degenerated or Aged Disc? A Post Contrast MRI Study. / Tibiletti, Marta; Galbusera, Fabio; Ciavarro, Cristina; Brayda-Bruno, Marco.

In: PLoS One, Vol. 8, No. 10, e76697, 11.10.2013.

Research output: Contribution to journalArticle

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