PURPOSE The aims were to use magnetic resonance imaging (MRI) to compare the efficacy of fat-suppressed proton-density turbo-spin-echo (FS-PD-TSE) images and T1-weighted (T1WIs) and T2-weighted images (T2WIs) in identifying cartilaginous endplate failure (CEF), and to propose a modified Rajasekaran classification based on the FS-PD-TSE sequence. METHODS Thirty-one lumbar disc herniation (LDH) cases were enrolled. Totally, 155 discs and 310 endplates were evaluated by MRI with T1W, T2W, and FS-PD-TSE sequences. Disc degeneration (DD), LDH grades, and the total endplate score (TEPS) of CEF were evaluated. Chi-square, Spearman rank correlation analysis, and multiclass logistic regression were used to compared the sensitivity in diagnosing CEF. A modified Rajasekaran classification based on FS-PD-TSE sequence was established to diagnose CEF. The multiclass logistic regression model was used to analyse the relationship between modified Rajasekaran classification and DD and LDH. RESULTS There were 117 (75.5%) segments with CEF in T1WIs, 115 (74.2%) in T2WIs, and 127 (81.9%) in FS-PD-TSE, respectively. Chi-square test showed FS-PD-TSE images were more sensitive than T1WIs and T2WIs (P < 0.05). Spearman rank correlation analysis revealed a significant correlation between TEPS and LDH and DD in T1WIs, T2WIs, and FS-PD-TSE images (P < 0.05). A multiclass logistic regression model showed that the incidence of DD and LDH significantly increased accordingly with increases in modified Rajasekaran classification (P < 0.05). CONCLUSION The FS-PD-TSE sequence has high diagnostic value for lumbar CEF. CEF is a risk factor for LDH. The new classification for lumbar CEF based on the FS-PD-TSE sequence has good predictive ability for LDH and DD. These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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FS-PD-TSE序列磁共振成像在诊断腰椎软骨终板失败中的诊断价值和临床意义。

目的目的是使用磁共振成像（MRI）来比较脂肪抑制的质子密度涡轮自旋回波（FS-PD-TSE）图像和T1加权（T1WI）和T2加权图像（T2WI）的功效）识别软骨终板失败（CEF），并根据FS-PD-TSE序列提出改良的Rajasekaran分类。方法纳入31例腰椎间盘突出症（LDH）。MRI用T1W，T2W和FS-PD-TSE序列总共评估了155个椎间盘和310个终板。评估了CEF的椎间盘退变（DD），LDH等级和终板总分（TEPS）。卡方检验，Spearman等级相关分析和多类逻辑回归用于比较诊断CEF的敏感性。建立了基于FS-PD-TSE序列的改良Rajasekaran分类法以诊断CEF。使用多类逻辑回归模型分析改良的Rajasekaran分类与DD和LDH之间的关系。结果T1WI中有CEF的段为117个（75.5％），T2WI中为115个（74.2％），FS-PD-TSE中为127个（81.9％）。卡方检验表明，FS-PD-TSE图像比T1WI和T2WI更敏感（P <0.05）。Spearman等级相关分析显示T1WI，T2WI和FS-PD-TSE图像中TEPS与LDH和DD之间存在显着相关性（P <0.05）。多类逻辑回归模型显示，随着改良的Rajasekaran分类的增加，DD和LDH的发生率显着增加（P <0.05）。结论FS-PD-TSE序列对腰椎CEF具有较高的诊断价值。CEF是LDH的危险因素。基于FS-PD-TSE序列的腰椎CEF的新分类对LDH和DD具有良好的预测能力。这些幻灯片可以在电子补充材料下找到。