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Journal ArticleDOI

Espetroscopia (1H) por ressonância magnética do disco intervertebral lombar no adulto e sua aplicação na rotina imagiológica

01 Nov 2014-Saúde & Tecnologia (Escola Superior de Tecnologia da Saúde de Lisboa)-Iss: 12, pp 24-32
TL;DR: The (1H) spectroscopy of intervertebral discs may contribute with a supplementary semiology to the conventional MRI and suggest that disc degeneration vs involution in higher degrees defines a decrease in the lactate’s peak.
Abstract: Aims – To assess the potential of magnetic resonance spectroscopy (1H‑MRS) in the diagnostic of degenerative disease of the lumbar disc and to advocate the adding of this technique in the classification of the invertebral disc involution vs degeneration (L4‑L5 and L5‑S1) in the clinical routine of lumbar pain status, not related with mechanic causes. Material and method – We studied 102 out of 123 lumbar intervertebral discs. The distribution among spaces was 61 discs at L4‑L5, 41 at L5‑S1 level and 34 at D12‑L1 level. The magnetic resonance studies were performed using a 1.5 T scan-ner. A single‑voxel Point Resolved Spectra Selection (PRESS) technique was used. The ratios [Lac/Nacetyl], [Nacetyl/(Lac+Lip)] and additionally the resonance of lipids were applied to evaluate the biochemistry of the discs, its involution, disc disruption and eventual susceptibility to initiate degeneration process. The ratios and the lipidic value of L4‑L5‑S1 discs were ascertained with the different behavior of D12‑L1. Furthermore, the comparison between L4‑L5, L5‑S1 and D12‑L1 discs was performed according with rating in T2 weighted (adjusted scale 1‑4 from Pfirrmann1 criteria). Results – Related to D12‑L1, the ratios and the lipids of L4‑L5‑S1 discs are statistically different. When used as a complementary of conventional T2 weighted, they have a good discrimination in the all degrees of disc involution vs degeneration. The ratio [Lac/Nacetyl] at L4‑L5‑S1 level was increased when compared to D12‑L1 (p=0.033 for disks with [1+2] score of involution and p=0.004 for disks with score [3+4]). These results suggest that disc degeneration vs involution in higher degrees defines a decrease in the lactate’s peak. The ratio [Nacetyl/(Lac+Lip)] provides a good discrimination of involution between scores [1+2] and [3+4] at L4‑L5 level, presenting the values of the ratios (mean 0.65 and 0.5 with p=0.04). The mean ratio of [Nacetyl/(Lac+Lip)] in the L4‑L5 disc was 1.8 times higher than that of L1‑D12. The lipid spectrum at L4‑L5‑S1 in the higher scores showed no constant prevalence in the resonance frequencies. Conclusion – The (1H) spectroscopy of intervertebral discs may contribute with a supplementary semiology to the conventional MRI. The resonances of L4‑L5 and L5‑S1 discs, involuted or degenerated, must be related with D12‑L1, which are more stable and have lower likelihood of disc degeneration.

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References
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Journal ArticleDOI
TL;DR: With age, a distinct pericellular matrix or “nest,” consisting of collagen fibrils, fine filaments, dense particles, and banded structures, formed around most cells with no apparent preference for viable or necrotic cells, suggesting accumulation of cell products.
Abstract: The cells of the intervertebral disc exist in a unique environment; not only are discs subject to large mechanical loads, they are the largest avascular structures in the body. To describe the ultrastructure and age changes in cells from human nucleus pulposus, we studied these cells in individuals ranging in age from the 26th week of fetal life to 91 years. Viable chondrocyte-like cells existed in specimens from all ages. The presence of Golgi cisternae and well-developed endoplasmic reticulum in these cells suggests that they are capable of producing and maintaining the extracellular matrix. Necrotic cells were also present in all samples, and many cells which appeared viable when examined by light microscopy proved to be necrotic when examined by electron microscopy. The percentage of necrotic cells increased with age from 2% or less in fetal specimens to over 50% in adults. In addition, with age, a distinct pericellular matrix or "nest," consisting of collagen fibrils, fine filaments, dense particles, and banded structures, formed around most cells with no apparent preference for viable or necrotic cells. Nest formation and increasing density of the cell nests may reflect accumulation of cell products.

255 citations

Journal ArticleDOI
20 Apr 2006-Spine
TL;DR: The results suggest that endplate abnormalities are related to inflammation and axon growth induced by TNF.
Abstract: Study Design.Immunohistochemistry for tumor necrosis factor (TNF) and protein gene product (PGP) 9.5 in vertebral endplates of patients with discogenic low back pain and Modic Type 1 or Type 2 endplate changes on MRI.Objectives.To examine whether inflammatory cytokines and nerve in-growth into the v

225 citations

Journal ArticleDOI
TL;DR: To compare PRESS and STEAM MR spectroscopy for assessment of liver fat in human subjects, the objective was to establish an apples-to-apples comparison for liver fat assessment.
Abstract: Purpose To compare PRESS and STEAM MR spectroscopy for assessment of liver fat in human subjects.

199 citations

Journal ArticleDOI
TL;DR: Observations suggest that disc cell proliferation is associated with disc degeneration and is the likely cause of cell cluster formation.
Abstract: Healthy human intervertebral discs contain relatively few cells and these are sparsely distributed. A characteristic feature of disc degeneration, however, is the appearance of cell clusters, particularly in damaged areas. How these clusters form is currently unknown. We have examined excised pathological human discs for evidence of cell proliferation. Disc sections were immunostained for the proliferating cell nuclear antigen (PCNA) and the proliferation-associated Ki-67 antigen. PCNA immunopositive cells were observed within degenerate discs, commonly though not exclusively, in cell clusters. Cells immunopositive for the Ki-67 antigen were less prevalent than those for PCNA, but similarly were observed frequently within clusters in degenerate discs. In contrast, immunopositivity for these markers was not common in less degenerate discs or in areas of the disc where cell clusters were not observed. These observations suggest that disc cell proliferation is associated with disc degeneration and is the likely cause of cell cluster formation.

163 citations