MRI-Based Inter-Vertebral Signal Concordance Index Is a Risk Factor of Osteoporotic Vertebral Compression Fracture: A...

MRI-derived vertebral bone quality (VBQ) score predicts osteoporotic vertebral compression fracture (OVCF) in a fat-dependent way. This retrospective study aimed to evaluate the predictive potential of inter-vertebral signal concordance index (ISCI), derived by MRI in a fat-independent way, as a novel factor for assessing the risk of OVCF.

Patients who suffered OVCF (OVCF group) and lumbar degenerative diseases (non-OVCF group) between January 2022 and July 2024 were included. The ISCI was calculated from the MRI signal intensity of the L1-L4 vertebrae, measured from the lumbar T1-weighted, T2-weighted, and short tau inversion recovery (STIR)-weighted sequences. The demographic data, including sex, age, body mass index (BMI), and medical history, were recorded. The ISCIs of the OVCF and non-OVCF groups were additionally compared. Inter-group comparisons were performed using the rank-sum, chi-square, or median test, as appropriate. Risk factors were identified by logistic regression, and correlations were assessed using Spearman's correlation coefficient.

A total of 448 patients were included in this study. The T1-ISCIs, T2-ISCIs, and STIR-ISCIs of the OVCF group were higher than those of the non-OVCF cohort (13.18 vs. 9.90, 14.69 vs. 10.68, and 19.31 vs. 15.67, respectively, all p < 0.001). Comparative analysis of the ISCIs across the subgroups categorized by sex and age revealed that the T1-ISCIs, T2-ISCIs, and STIR-ISCIs were higher in the OVCF group. Additionally, there were no significant differences in the ISCIs across fresh, old, and fresh + old fracture type subgroups. The results of multivariate logistic regression analysis revealed that the STIR-ISCI (odds ratio (OR) = 1.025, p = 0.013) could serve an independent predictive factor for assessing the risk of OVCF.

The study evaluated a novel index for predicting the risk of OVCF. The T1-ISCI and STIR-ISCI could serve as potential predictive factors for evaluating the risk of OVCF in clinical practice.