Characteristics of MRI-based vertebral bone quality scores in elderly patients with vertebral fragility fractures

ObjectiveTo explore the characteristics of vertebral bone quality (VBQ) scores in patients with vertebral fragility fractures, including VBQ score and single-level VBQ score, and evaluate their effectiveness as predictors.MethodsThe VBQ scores were measured using T1-weighted MRI images. VBQ scores were compared in patients with different times of previous fragility fractures. In addition, patients with fractures were matched for age and sex with patients without fractures, and VBQ scores were compared between the two groups. Finally, the predictive efficiency of VBQ scores for vertebral fragility fractures was analyzed by the receiver-operator curve (ROC).ResultsThe average VBQ score and single-level VBQ score in patients with fractures were 3.48 +/- 0.56 and 3.60 +/- 0.60 and no difference among patients with different times of previous fractures. As for the age- and sex-matched patients, fracture patients had higher VBQ scores (VBQ score: 3.48 +/- 0.56 vs. 2.88 +/- 0.40, p < 0.001; single-level VBQ score: 3.60 +/- 0.60 vs. 2.95 +/- 0.44, p < 0.001). The AUCs using the VBQ score and single-level VBQ score to predict fragility fractures were 0.815 and 0.817, respectively. The optimal thresholds of the VBQ score and single-level VBQ score for predicting fragility fractures were 3.22 and 3.16, respectively.ConclusionMRI-based VBQ scores are important predictors of vertebral fragility fracture but have no predictive value for the recurrence of fractures in patients with a history of fragility fractures. The VBQ score of 3.22 and single-level VBQ score of 3.16 are optimal thresholds that can be used when using lumbar MRI scans to identify individuals at high risk for fragility fractures.

Automated summary

This study measured VBQ scores using T1-weighted MRI images and compared them in patients with different previous fragility fracture times. Additionally, fracture patients had higher VBQ scores compared to age- and sex-matched non-fracture patients. The VBQ scores showed good predictive efficiency for fragility fractures.