MRI-Based Vertebral Bone Quality Score and Paravertebral Muscle Parameters for Identifying Osteoporotic Vertebral...

Area of Science:

• Radiology
• Orthopedics
• Geriatrics

Background:

• Osteoporotic vertebral compression fractures (OVCFs) are common but frequently undiagnosed.
• Bone mineral density (BMD) is the standard assessment, but MRI parameters of bone and muscle quality may offer additional diagnostic value.
• Limited sex-specific analyses exist despite known differences in OVCF incidence and hormonal influences.

Purpose of the Study:

• To investigate associations between MRI-derived vertebral bone quality (VBQ) score, psoas muscle index (PMI), and paravertebral muscle fat infiltration (FI) fraction with OVCFs.
• To evaluate the diagnostic performance of these MRI parameters in distinguishing between sexes.

Main Methods:

• Retrospective analysis of 260 subjects (≥50 years), including 130 OVCF patients and 130 controls.
• MRI measurements (VBQ, PMI, FI) and CT-derived BMD were performed by blinded observers.
• Statistical analyses included t-tests, chi-squared tests, logistic regression, and ROC curve analysis with bootstrap validation.

Main Results:

• OVCF patients showed higher VBQ and FI, but lower PMI and BMD compared to controls.
• Paravertebral muscle fat infiltration (FI) was independently associated with OVCFs exclusively in females.
• A multi-parametric MRI model (VBQ + FI + PMI) demonstrated superior diagnostic performance in females (AUC=0.896) versus males (AUC=0.720).

Conclusions:

• Vertebral bone quality (VBQ), psoas muscle index (PMI), and fat infiltration (FI) exhibit significant sex-specific correlations with OVCFs.
• The combined MRI approach shows promise as a diagnostic tool for OVCFs in individuals over 50.
• This multi-parametric MRI model appears particularly valuable for diagnosing OVCFs in the female population.