Determinants of diurnal variation in lumbar intervertebral discs and paraspinal muscles: A prospective quantitative magnetic resonance imaging study. Issue 160 (March 2023)

• Record Type: Journal Article
• Authors: Liu, Chanyuan; Ran, Jun; Morelli, John N.; Hou, Bowen; Li, Yitong; Li, Xiaoming
• Is Part Of: European journal of radiology. Issue 160(2023)
• Publication Date: 2023-03
• Subjects: Magnetic resonance imaging -- Diurnal variation -- Lumbar intervertebral disc -- Paraspinal muscle -- Lifestyle behavior; LBP low back pain -- MRI magnetic resonance imaging -- T2 T2 relaxation time -- MD mean diffusivity -- MK mean kurtosis -- DKI diffusion kurtosis imaging -- TIB time in night bed-rest -- ROI region of interest -- A-AF anterior annulus fibrosus -- NP nucleus pulposus -- PI-AF posterior inner annulus fibrosus -- PO-AF posterior outer annulus fibrosus -- T2-DS the diurnal shift in T2 relaxation time -- MD-DS the diurnal shift in mean diffusivity -- MK-DS the diurnal shift in mean kurtosis -- T2-DDV the degree of diurnal T2 relaxation time variation -- MD-DDV the degree of diurnal mean diffusivity variation -- MK-DDV the degree of diurnal mean kurtosis variation -- ICC the intra-class correlation coefficient; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2023.110712
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Normal and degenerative lumbar discs have different diurnal variations. Lifestyle and weight have causal effects on the diurnal variation of lumbar discs. T2 mapping and DKI are promising tools for clinical evaluation of disc biomechanics. T2 mapping can characterize diurnal water fluctuations in paraspinal muscles in-vivo. Abstract: Purpose: To prospectively investigate the determinants of diurnal variations in lumbar intervertebral discs and paraspinal muscles. Method: 71 females aged 19 ∼ 31 years were examined by morning-evening T2 mapping/diffusion kurtosis imaging (DKI), with weight and lifestyle information (time in night bed-rest [TIB], bed-napping, activity time, and sitting time) assessed by standardized questionnaires. Diurnal shifts in T2, mean diffusivity and mean kurtosis (T2-DS, MD-DS and MK-DS; morning-value minus evening-value) were evaluated for L4-S1 discs (normal, Pfirrmann grade Ⅰ/Ⅱ; degenerative, III/IV). T2 and T2-DS were assessed for L4/5 multifidus and erector spinalis. Results: For normal discs, bed-napping correlated with MD-DS and MK-DS in disc entirety (p = 0.001 and 0.004); increased activity time suggested higher T2-DS in nucleus pulposus (p = 0.004); prolonged sitting time predicted greater T2-DS in disc entirety and posterior inner annulus fibrosus (PI-AF, p ≤ 0.011); decreased TIB and weight suggested lower T2-DS and higher MK-DS in PI-AF (p = 0.001 ∼ 0.035). For degenerative discs, bed-napping predicted lower T2-DS in nucleus pulposus and PI-AF (p = 0.019); increased TIB suggested higher T2-DS and lower MK-DS in PI-AF (p = 0.006 and 0.034); longer sitting time predicted higher MK-DS in PI-AF (p = 0.020). Paraspinal muscles exhibited diurnal T2 variation (p < 0.001) which did not correlate with lifestyle factors (p > 0.050). Conclusions: Lifestyle and weight have causal effects on the diurnal variation of lumbar discs. Bed-rest may correlate with disc hydration and microstructural stability reserves for subsequent daytime activities. Sitting behavior could induce greater dehydration in normal discs and may alleviate diurnal microstructural rearrangement in degenerative discs. T2 mapping and DKI are promising tools to evaluate disc biomechanics in clinics.