• Feifei Zeng, Yunfei Zha, Liang Li, Dong Xing, Wei Gong, Lei Hu, and Yang Fan.
• Department of Radiology, Renmin Hospital of Wuhan University, 99, Zhangzhidong Road, Wuhan, 430060, Hubei, China.
• Eur Spine J. 2019 Sep 1; 28 (9): 2169-2178.

PurposeTo assess the feasibility of diffusion kurtosis imaging (DKI) for diagnosing lumbar intervertebral disk degeneration (IDD) and to compare the potential of DKI and T2* mapping in the diagnosis of early IDD.MethodsSagittal T2WI, DKI, and T2* mapping were performed in 75 subjects with 375 lumbar intervertebral disks at a 3.0-T MRI. DKI-related parameters including mean kurtosis (MK), mean diffusivity (MD), fractional anisotropy (FA), and T2* values were calculated for each disk which was segmented into three regions: nucleus pulposus (NP), anterior annulus fibrosus (AAF), and posterior annulus fibrosus (PAF).ResultsMK and FA were positively correlated with Pfirrmann grade (all P < 0.001). MD and T2* were negatively correlated with Pfirrmann grade (all P < 0.001) except for T2* value of AAF (r = 0.087, P > 0.05). MK and FA values increased, while MD and T2* values decreased with age. No statistical significance was found between men and women (P > 0.05). Cephalic lumbar disks (L1/L2 and L2/L3) got lower MK and FA values than caudal lumbar disks (L4/L5 and L5/S1) (all P < 0.05), while cephalic lumbar disks got higher MD value than caudal lumbar disks (all P < 0.05). ROC analysis demonstrated that MK, MD, and FA showed significantly higher diagnostic accuracies than T2*, especially in NP and PAF.ConclusionsDKI can be used to assess human lumbar IDD. And DKI was more sensitive to the quantitative detection of early lumbar IDD than T2* mapping. These slides can be retrieved under Electronic Supplementary Material.

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