MRI OF MARROW CHANGES IN THE VERTEBRAL BODIES ADJACENT TO ENDPLATES IN DEGENERATIVE LUMBAR DISC DISEASE.

Abstract

MR studies of the lumbar spine in 57 patients [285 disc spaces] were analyzed, to assess the appearance and frequency of the bone marrow signal changes in the vertebral bodies adjacent to the normal and degenerative discs. Degenerative changes were found in 144 of 285 discs. Signal abnormalities of bone marrow adjacent to the endplates were identified in 52 of 144 discs (36.1%). In 44 of 52 discs [84.6%], there is an area of relatively increased signal intensity in T1WI & T2WI in the vertebral bodies adjacent to the endplates. In 6 of 52 [11.5%] decreased signal intensity on both T1WI & T2WI was noted in focal and bandlike appearance. In the other 2 discs [3.9%] decreased signal was noted on T1WI and increased signal evidence in T2WI. These marrow changes were not present adjacent to the normal discs. The signal alteration suggests three patterns of bone marrow change; fat phase, sclerotic phase and edematous phase respectively. The ages of the patients with marrow changes in edematous phase (41 and 43 years old) are less than the mean ages of the other two groups (65.52 and 59.4 years respectively).
We conclude that bandlike and focal areas of signal changes in the bone marrow adjacent to degenerative intervertebral discs can occur on MR images of the lumbar spine and should not be confused with signal changes from tumor or infectious process involving the disc space and adjacent vertebral endplates.