Medical College of Wisconsin
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In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework. Eur Spine J 2015 Nov;24(11):2442-8



Pubmed ID




Scopus ID

2-s2.0-84945459321   21 Citations


PURPOSE: To evaluate the role of apparent diffusion coefficient (ADC) as a quantitative means to assess the degree of intervertebral disc (IVD) degeneration contextually within the framework of a widely used Pfirrmann classification rather than in a direct correlation with Pfirrmann grades.

METHODS: DWI and T2-weighted (T2w) of lumbar spine were acquired from nine healthy volunteers (age range 27-62 years, mean age 45 years) with a 3T MR scanner. ADC values were obtained from each of the five lumbar discs via a pixel-by-pixel ADC calculation as well as via region of interest-averaged image intensities. Disc degeneration was assessed by a scoring system via sequential application of Pfirrmann scale and use of intensity ratio of IVD/cerebrospinal fluid in T2w for discs in each Pfirrmann grade to be further separated.

RESULTS: A significant correlation was observed between degenerative scores and ADC independent of how ADC was obtained (Spearman's ρ < -0.85, P < 2 × 10(-14)).

CONCLUSIONS: This study demonstrates that previously perceived as an overlap in ADC value existing between different degenerative categories based on a visual inspection can be viewed as a quantitative role of ADC in assessment of disc degeneration. This reinforces the Pfirrmann classification system but also proceeds beyond mere qualitatively determining morphologic states.

Author List

Yu HJ, Bahri S, Gardner V, Muftuler LT


Lutfi Tugan Muftuler PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Intervertebral Disc Degeneration
Lumbar Vertebrae
Magnetic Resonance Imaging
Middle Aged
Severity of Illness Index