T2-Weighted MRI-Based Vertebral Bone Quality Score is an Independent Risk Factor of Osteoporotic Vertebral Compression Fracture: An Age- and Sex-Matched Study

Study DesignA case-controlled retrospective study.ObjectiveWe aimed to explore the effectiveness of MRI-based VBQ scores derived by different MRI sequences in assessing risk of an osteoporotic vertebral compression fracture (OVCF) in age- and sex-controlled patients.MethodsThis retrospective study included patients hospitalized for OVCF (fracture group) and degenerative lumbar disease (non-fracture group) from July 2022 to July 2024. Patients in both groups were matched for sex and age in a 1:1 ratio. VBQ scores were acquired from non-contrast lumbosacral MRI T1-weighted, T2-weighted, and short tau inversion recovery (STIR)-weighted sequences. A receiver operating characteristic (ROC) curve and area under the ROC (AUC) were plotted to evaluate the diagnostic accuracy.ResultsA total of 168 patients (n = 84 in each group) were included. VBQ-T1 scores were higher in the fracture group (4.4 vs 4.1, <i>P</i> = 0.001), with an AUC of 0.641 to predict OVCF. VBQ-T2 scores were higher in the fracture group (0.60 vs 0.55, <i>P</i> < 0.001), with an AUC of 0.697. Additionally, VBQ-T2-STIR scores were higher in the fracture group (0.99 vs 0.83, <i>P</i> = 0.004), with an AUC of 0.644. Multivariate logistic regression analysis identified VBQ-T2, rather than VBQ-T1 or VBQ-T2-STIR, as an independent risk factor for OVFC.ConclusionThis study evaluated the MRI-based VBQ scores in assessing risk of OVCF based on age- and sex-matched cases. The VBQ-T2 score appears most promising for evaluating the risk of OVCF in clinical practice.