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. 2023 Jul 24;24(1):602.
doi: 10.1186/s12891-023-06615-3.

Nucleus high intensity in the T2-weighted MRI is a potential predictor of annulus tear in cervical injured patients: a case comparative study

Shengyu Wan  1 , Jian Zhang  1 , Chao Wu  1 , Xu Lin  1 , Jingchi Li  2 , Fan Wu  1 , Zifan Zhang  3 , Lipeng He  4
Affiliations

Nucleus high intensity in the T2-weighted MRI is a potential predictor of annulus tear in cervical injured patients: a case comparative study

Shengyu Wan et al. BMC Musculoskelet Disord. .

Abstract

Background: Segmental fusion operations assume paramount significance for individuals afflicted by full layers of annulus tears as they avert the perils of rapid disc degeneration and segmental instability. Structures with high signal intensity in the T2-weighted MRI can predict potential damage to the injured segment. Since local structures are shortly related biomechanically, this may be an effective predictor for annulus tears.

Methods: A retrospective analysis of the clinical data of 57 patients afflicted by cervical injuries and subjected to single-segment ACDF has been performed in this study. The surgeon performed intraoperative exploration to assess the integration status of the annulus. The signal intensity of the prevertebral space, nucleus, and injured vertebral bodies were judged in the T2-weighted imaging data. Regression analyses identified independent predictors for annulus tears, and the area under the receiver operating characteristic curve (AUC) was computed to evaluate the predictive performance of potential independent predictors.

Results: The occurrence of nucleus high intensity was significantly higher among individuals with annulus tears, and the nucleus high intensity was deemed an independent predictor for determining the presence of intraoperative visible annulus tears in patients with cervical injuries. AUC for nucleus high intensity was calculated as 0.717, with a corresponding p-value less than 0.05.

Conclusions: In the realm of diagnosing annulus tears in injured cervical patients, nucleus high intensity in the T2-weighted MRI emerges as a promising predictive factor. Notably, this applies specifically to patients devoid of fracture and visible annulus tears in their MRI scans. Such positive outcomes should be regarded as prospective indications for ACDF.

Keywords: Annulus tears; Independent predictors; Injured cervical patients; Nucleus high intensity; surgicalSurgical indications.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Schematic for patients inclusion and exclusion
Fig. 2
Fig. 2
Schematic for MRI-based parameters
Fig. 3
Fig. 3
Differences in MRI-based parameters between patients with and without intraoperative visible annulus tears
Fig. 4
Fig. 4
ROC curves of different MRI-based parameters
Fig. 5
Fig. 5
A typical case with nucleus high intensity and intraoperatively observed full laters annulus tear (Yellow arrow: intraoperative observed annulus tears)
See this image and copyright information in PMC

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