Clinical radiology · 2026
Dual-energy computed tomography (CT) bone marrow oedema and fat fraction maps for characterisation of lumbar vertebral endplate degeneration.
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Shinohara Y, Sasaki F, Kominami M, Sugawara T, Kinoshita T
Аннотация
AIM: Nonsclerotic endplate degeneration (ED) is difficult to identify on single-energy computed tomography (CT), whereas magnetic resonance imaging (MRI) can demonstrate it as Modic changes type 1 (MC1) and 2 (MC2), which pathologically correspond to inflammatory and fatty stages, respectively. The aim of this study is to investigate the potential of dual-energy CT (DECT) to evaluate ED.
MATERIALS AND METHODS: Seventy-two patients who underwent noncontrast lumbar spine MRI and DECT were reviewed. Sagittal MR findings of all endplates were classified based on the MCs, and the vertical heights of MCs and their vertebral bodies were measured to calculate height rates (HRs) for ED. The HRs on the bone marrow image (BM) and fat fraction map (FF) were calculated to compare with those of MC1 and MC2, respectively. Quantitative evaluation was performed by setting ROIs in ED on BM and FF corresponding to the MC1 and MC2 lesions, respectively (P < 0.05 as statistically significant).
RESULTS: Among the 31 endplates with MC1, BM visually showed high attenuation in 28 (90.3%), indicating an oedematous lesions. Among the 54 endplates with MC2, FF visualised a high fat percentage in 48 (88.9%), indicating fatty deposition. The HRs for ED on DECT were significantly correlated with those on MR images (MC1 and BM: r = 0.798, P < 0.05; MC2 and FF: r = 0.918, P < 0.05). The median DECT values in ED were significantly higher than those in normal vertebral bodies (BM [Hounsfield unit, HU]: 6.10 vs -44.4, P < 0.05; FF [%]: 101.30 vs 54.9, P < 0.05).
CONCLUSION: DECT can detect inflammatory and fatty stages of lumbar ED, which respectively correspond to MC1 and MC2 on MRI.
MATERIALS AND METHODS: Seventy-two patients who underwent noncontrast lumbar spine MRI and DECT were reviewed. Sagittal MR findings of all endplates were classified based on the MCs, and the vertical heights of MCs and their vertebral bodies were measured to calculate height rates (HRs) for ED. The HRs on the bone marrow image (BM) and fat fraction map (FF) were calculated to compare with those of MC1 and MC2, respectively. Quantitative evaluation was performed by setting ROIs in ED on BM and FF corresponding to the MC1 and MC2 lesions, respectively (P < 0.05 as statistically significant).
RESULTS: Among the 31 endplates with MC1, BM visually showed high attenuation in 28 (90.3%), indicating an oedematous lesions. Among the 54 endplates with MC2, FF visualised a high fat percentage in 48 (88.9%), indicating fatty deposition. The HRs for ED on DECT were significantly correlated with those on MR images (MC1 and BM: r = 0.798, P < 0.05; MC2 and FF: r = 0.918, P < 0.05). The median DECT values in ED were significantly higher than those in normal vertebral bodies (BM [Hounsfield unit, HU]: 6.10 vs -44.4, P < 0.05; FF [%]: 101.30 vs 54.9, P < 0.05).
CONCLUSION: DECT can detect inflammatory and fatty stages of lumbar ED, which respectively correspond to MC1 and MC2 on MRI.