Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Diurnal Variation in Hydration of the Cervical Intervertebral Disc Assessed Using T2 Mapping of Magnetic Resonance Imaging

  • Chanyuan Liu (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Jingyi Wang (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Bowen Hou (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Yitong Li (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • John N. Morelli (The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine) ;
  • Peisen Zhang (Department of Rehabilitation Medicine, School of Medicine, Guangzhou First People's Hospital, South China University of Technology) ;
  • Jun Ran (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Xiaoming Li (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology)
  • Received : 2021.12.21
  • Accepted : 2022.04.01
  • Published : 2022.06.01
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Abstract

Objective: The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods: C3-C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2-C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 - evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results: T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion: This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.

Keywords

Acknowledgement

This study was supported by the National Natural Science Foundation of China (NSFC) (No. 31630025, No. 81930045 and No. 81901715).

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