Modic changes, a common observation in MR imaging, are signal intensity changes in vertebral body marrow adjacent to the endplates of degenerative discs.

Michael T. Modic, MD, professor of radiology and neurology at Case Western in Cleveland, wrote about these changes in the journal Radiology in 1988, and his name has been associated with these changes ever since.

 

Modic changes take 3 main forms:

• Type I
  • Decreased signal on T1, and increased signal on T2.
  • Represents marrow edema.
  • Associated with an acute process.
  • Histological examination shows disruption and fissuring of the endplate and vascularized fibrous tissues within the adjacent marrow.
• Type II — the most common type
  • Increased signal on T1, and isointense or slightly hyperintense signal on T2.
  • Represents fatty degeneration of subchondral marrow.
  • Associated with a chronic process.
  • Histological examination shows endplate disruption with yellow marrow replacement in the adjacent vertebral body.
  • Type I changes convert to Type II changes with time, while Type II changes seem to remain stable.
• Type III
  • Decreased signal on both T1 and T2.
  • Correlate with extensive bony sclerosis on plain radiographs.
  • Histological examination shows dense woven bone; hence, no marrow to produce MRI signal.

MODIC CHANGES on MRI
	T1	T2	Significance
TYPE 1	-	+	edema
TYPE II	+	= or slight +	fatty degeneration
TYPE III	-	-	bony sclerosis

 

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Susan L. Vlasuk, DC, DACBR  •  Mill Creek, WA  •  (425) 451-1199
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