• J Magn Reson Imaging · Mar 2017

    Glycosaminoglycan chemical exchange saturation transfer in human lumbar intervertebral discs: Effect of saturation pulse and relationship with low back pain.

    • Tatsuhiro Wada, Osamu Togao, Chiaki Tokunaga, Ryohei Funatsu, Yasuo Yamashita, Kouji Kobayashi, Yasuhiko Nakamura, and Hiroshi Honda.
    • Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan.
    • J Magn Reson Imaging. 2017 Mar 1; 45 (3): 863-871.

    PurposeTo evaluate the dependence of saturation pulse power and duration on glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging and assess the degeneration of human lumbar intervertebral discs (IVDs) using this method.Materials And MethodsAll images were acquired on a 3T magnetic resonance imaging (MRI) scanner. The CEST effects were measured in the glycosaminoglycan (GAG) phantoms with different concentrations. In the human study, CEST effects were measured in the nucleus pulposus of IVD. We compared the CEST effects among the different saturation pulse powers (0.4, 0.8, and 1.6 μT) or durations (0.5, 1.0, and 2.0 sec) at each Pfirrmann grade (I-V). The relationship between the CEST effects and low back pain was also evaluated.ResultsThe phantom study showed high correlations between the CEST effects and GAG concentration (R2  = 0.863, P < 0.0001, linear regression). In the human study, the CEST effect obtained with the 0.8 μT power was significantly greater than those obtained with 0.4 (P < 0.01) and 1.6 μT power (P < 0.05) at Pfirrmann grade I. The CEST effect obtained with a 1.0-sec duration was significantly greater than those derived with 0.5 and 2.0 sec (P < 0.01) durations at Pfirrmann grades I and II. The CEST effects in the group with moderate low back pain were significantly lower than those in the groups without pain (P < 0.001) and with mild pain (P = 0.0216).ConclusionThe contrast of gagCEST imaging in the lumbar IVDs varied with saturation pulse power and duration. GagCEST imaging may serve as a tool for evaluating IVD degeneration in the lumbar spine.Level Of Evidence2 J. Magn. Reson. Imaging 2017;45:863-871.© 2016 International Society for Magnetic Resonance in Medicine.

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