Normative vertebral deformity measurements in a clinically relevant population using magnetic resonance imaging

Osteoporosis is the leading cause of vertebral fractures. Dual-energy X-ray absorptiometry (DXA) and radiographs are traditionally used to detect osteoporosis and vertebral fractures/deformities. Magnetic resonance imaging (MRI) can be utilized to detect the relative severity of vertebral deformities using three-dimensional information not available in traditional DXA and lateral two-dimensional radiography imaging techniques.

To generate normative vertebral parameters in women using MRI and DXA scans, determine the correlations between MRI-calculated vertebral deformities and age, DXA T-scores, and DXA Z-scores, and compare MRI vertebral deformity values with radiography values previously published in the literature.

This study is a retrospective vertebral morphometric analysis conducted at our institution. The patient sample included MR images from 1638 female patients who underwent both MR and DXA imaging between 2005 and 2014. Biconcavity, wedge, crush, anterior height (H_a)/posterior height (Hp), and middle height (H_m)/posterior height values were calculated from the MR images of the patient's vertebrae. Associations between vertebral deformity values, patient age, and DXA T-scores were analyzed using Spearman correlation. The MRI-derived measurements were compared with radiograph-based calculations from population-based data compiled from multiple studies.

Age was positively correlated with lumbar H_m/H_p (P = 0.04) and thoracic wedge (P = 0.03) and biconcavity (P = 0.001) and negatively correlated with thoracic H_a/H_p (P = 0.002) and H_m/H_p (P = 0.001) values. DXA T-scores correlated positively with lumbar H_m/H_p (P < 0.0001) and negatively with lumbar wedge (P = 0.046), biconcavity (P < 0.0001), and H_a/H_p (P = 0.046) values. Qualitative analysis revealed that H_a/H_p differed between MRI and radiography population-based data by no more than 0.3 and H_m/H_p by a maximum of 1.2.

Compared with traditional imaging techniques, MRI detects vertebral deformities with high accuracy and reliability. It may be a sensitive, ionizing, radiation-free tool for use in clinical settings.