Correlation between diffusion in lumbar intervertebral disks and lumbar artery status: Evaluation with fresh blood imaging technique

Purpose: To evaluate the correlation of the lumbar artery status with the diffusion values in lumbar vertebral disks in patients with low back problems using a fresh blood imaging (FBI) technique. Materials and Methods: First, both digital subtraction angiography (DSA) and MR angiography (MRA) was performed, and the weighted kappa value between DSA and MR angiography in evaluating the status of lumbar arteries was calculated. Then, The sagittal diffusion-weighted MR images in 260 intervertebral disks (L1-2 to L4-5) and MR angiographic images using FBI technique in the corresponding 260 lumbar artery pairs (total of 520 arteries) of the 65 patients with low back problems were separately evaluated by two radiologists. Results: The weighted kappa value between DSA and MRA in evaluating the status of lumbar arteries in both observes indicated good agreement. There were significant correlations between the status of lumbar arteries and the ADC values of the lumbar disks in all orthogonal directions (x, y, and z) at all intervertebral levels except L4-5 by both observers (P < 0.001). Conclusion: There is a strong association between the diminished flow in lumbar arteries and the decreased diffusion of lumbar intervertebral disks at all intervertebral levels except at L4-5.