Magnetic resonance myelography evaluation of the lumbar spine end plates and intervertebral disks

Purpose: To evaluate the value of magnetic resonance (MR) myelography in the evaluation of intervertebral disk and end-plate degenerative changes in the lumbar spine. Material and Methods: Conventional MR and MR myelography examinations were performed in 150 consecutive patients (69 F and 81 M, mean age 45 +/- 15 years, range 1889). Sagittal T1 and T2-weighted TSE images were compared to MR myelography obtained with a multishot-TSE-T2-weighted sequence (4000/250/fat suppression). Coronal, sagittal, and both oblique MR myelography projections were obtained. Image analysis was carried out independently by two radiologists who categorized lumbar disks into normal, degenerated, or edematous; and vertebral end plates into normal, edematous, or with fatty changes. The proportions were statistically compared at every lumbar intervertebral level. Results: There was good agreement in the classification of disk disease (Kappa: 0.8-0.9). MRI detected a larger number of disk degeneration and end-plate fatty metamorphosis, while the MR myelography technique depicted a larger number of edematous disks and end plates. Conclusion: MR myelography was of limited value in detecting the same vertebral end-plate changes observed in MRI, although with similar findings in disk disease. However, the higher detection of edema changes by MR myelography should be analyzed prospectively, as it could be more sensitive than conventional MR sequences.