Novel UTE MRI Disc Sign (UDS) and its clinical relevance

Abstract

INTRODUCTION: Ultra-short time-to-echo (UTE) MRI assesses short T2 components. Our groupWe identified a new imaging biomarker on UTE - the “UTE Disc Sign (UDS)”. This study aims to assessed the UDS prevalence, association with other MRI phenotypes as well as pain/disability profiles. METHODS: 76 Southern Chinese subjects were recruited (51.3% male; mean age: 50.6 years) for T2W, T1-rho and UTE MRI of the lumbar spine (n=380 discs). T2W MRI was used to assess disc degeneration and other phenotypes, and T1-rho MRI was implemented to obtain quantitative proteoglycan disc profiles. UDS was detected on UTE as a hyper- or hypo-intense band across a disc. Subject demographics, pain and disability profiles were obtained. RESULTS: The UDS was noted in 25% subjects (57.9% males; mean age: 52.6 years). 80% UDS occurred at the lower lumbar levels (L3-S1). 26.3% had multi-level UDS. Subjects with UDS had significantly more disc degeneration, disc displacement, spondylolisthesis, and Modic changes (p<0.001). T1-rho values were lower in UDS discs than non-UDS discs (p=0.022). The majority of UDS could not be detected on T2W MRI. 88% of UDS individuals had LBP. Number of UDS disc levels significantly correlated with worse ODI scores (r=0.303; p=0.013), whereas traditional T2W degenerative grading did not (r=0.234; p=0.057). DISCUSSION: This is the first study to report “UDS” in humans. UDS is a novel imaging biomarker highly associated with spine degeneration and negative clinical profile. UDS serves as a new phenotype that broadens our understanding of degenerative disc changes and may have potential clinical utility.