Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon Sequences

ABSTRACT Objective Increased marrow fat fraction (MFF) of vertebrae was detected in patients with osteoporosis. However, MFF of the fractured vertebrae decreased significantly following the fracture. The aim of this study was to assess the predictive value of fractured vertebrae MFF quantified on T2...

Full description

Saved in:
Bibliographic Details
Main Authors: Pengguo Gou, Rui Wang, Zhihui Zhao, Yunguo Wang, Yuan Xue
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.70098
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849699346546688000
author Pengguo Gou
Rui Wang
Zhihui Zhao
Yunguo Wang
Yuan Xue
author_facet Pengguo Gou
Rui Wang
Zhihui Zhao
Yunguo Wang
Yuan Xue
author_sort Pengguo Gou
collection DOAJ
description ABSTRACT Objective Increased marrow fat fraction (MFF) of vertebrae was detected in patients with osteoporosis. However, MFF of the fractured vertebrae decreased significantly following the fracture. The aim of this study was to assess the predictive value of fractured vertebrae MFF quantified on T2‐weighted Dixon sequences for the prediction of nonunion risk of acute OVCF. Materials and Methods Medical records of 39 patients with OVCF, including a total of 60 fractured vertebrae, were reviewed retrospectively. Fractured vertebrae in the acute phase were grouped into the nonunion group (20 vertebrae) and the union group (40 vertebrae), based on the OVCF prognosis confirmed by computer tomography (CT). MFF of the fractured vertebrae was quantitatively assessed with the software Matlab on T2‐weighted Dixon sequences. Interclass correlation coefficients (ICC) were analyzed to assess the repeatability of MFF measurement. Binary logistic regression analysis was performed to determine the relative contribution of the MFF for predicting the prognosis of OVCF. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic performance of MFF. Results The ICC indicated that the repeatability of MFF measurement was excellent (all p < 0.001). The MFF (42.25% ± 26.61%) decreased significantly compared to the value before OVCF (79.84% ± 9.65%) (p < 0.001). The MFF of the fractured vertebrae was lower in the nonunion group (16.40% ± 15.65%) than in the union group (55.18% ± 20.93%) (p < 0.001). Binary logistic regression analysis indicated that MFF of fractured vertebrae could independently predict the prognosis of acute OVCF (p < 0.001). ROC analysis indicated the area under the curve was 0.928 (95% CI, 0.831–0.979, p < 0.0001). Conclusions The MFF quantified on T2‐weighted Dixon sequences was a useful marker for assessing the nonunion risk of acute OVCF. The fractured vertebra with low MFF should be carefully monitored for nonunion.
format Article
id doaj-art-7716e0c5d1734f4cb2c535088b09c86e
institution DOAJ
issn 1757-7853
1757-7861
language English
publishDate 2025-08-01
publisher Wiley
record_format Article
series Orthopaedic Surgery
spelling doaj-art-7716e0c5d1734f4cb2c535088b09c86e2025-08-20T03:18:38ZengWileyOrthopaedic Surgery1757-78531757-78612025-08-011782405241210.1111/os.70098Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon SequencesPengguo Gou0Rui Wang1Zhihui Zhao2Yunguo Wang3Yuan Xue4Department of Orthopedic Surgery Tianjin Medical University General Hospital Tianjin ChinaDepartment of Orthopedic Surgery Tianjin Medical University General Hospital Tianjin ChinaDepartment of Orthopedic Surgery Tianjin Medical University General Hospital Tianjin ChinaDepartment of Orthopedic Surgery Tianjin Medical University General Hospital Tianjin ChinaDepartment of Orthopedic Surgery Tianjin Medical University General Hospital Tianjin ChinaABSTRACT Objective Increased marrow fat fraction (MFF) of vertebrae was detected in patients with osteoporosis. However, MFF of the fractured vertebrae decreased significantly following the fracture. The aim of this study was to assess the predictive value of fractured vertebrae MFF quantified on T2‐weighted Dixon sequences for the prediction of nonunion risk of acute OVCF. Materials and Methods Medical records of 39 patients with OVCF, including a total of 60 fractured vertebrae, were reviewed retrospectively. Fractured vertebrae in the acute phase were grouped into the nonunion group (20 vertebrae) and the union group (40 vertebrae), based on the OVCF prognosis confirmed by computer tomography (CT). MFF of the fractured vertebrae was quantitatively assessed with the software Matlab on T2‐weighted Dixon sequences. Interclass correlation coefficients (ICC) were analyzed to assess the repeatability of MFF measurement. Binary logistic regression analysis was performed to determine the relative contribution of the MFF for predicting the prognosis of OVCF. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic performance of MFF. Results The ICC indicated that the repeatability of MFF measurement was excellent (all p < 0.001). The MFF (42.25% ± 26.61%) decreased significantly compared to the value before OVCF (79.84% ± 9.65%) (p < 0.001). The MFF of the fractured vertebrae was lower in the nonunion group (16.40% ± 15.65%) than in the union group (55.18% ± 20.93%) (p < 0.001). Binary logistic regression analysis indicated that MFF of fractured vertebrae could independently predict the prognosis of acute OVCF (p < 0.001). ROC analysis indicated the area under the curve was 0.928 (95% CI, 0.831–0.979, p < 0.0001). Conclusions The MFF quantified on T2‐weighted Dixon sequences was a useful marker for assessing the nonunion risk of acute OVCF. The fractured vertebra with low MFF should be carefully monitored for nonunion.https://doi.org/10.1111/os.70098fracturemagnetic resonance imagingmarrow fat fractionnonunionosteoporosis
spellingShingle Pengguo Gou
Rui Wang
Zhihui Zhao
Yunguo Wang
Yuan Xue
Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon Sequences
Orthopaedic Surgery
fracture
magnetic resonance imaging
marrow fat fraction
nonunion
osteoporosis
title Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon Sequences
title_full Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon Sequences
title_fullStr Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon Sequences
title_full_unstemmed Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon Sequences
title_short Predicting the Nonunion of the Acute Osteoporotic Vertebral Compression Fracture Following Low‐Energy Injuries by Quantifying Vertebral Marrow Fat Fraction on T2‐Weighted Dixon Sequences
title_sort predicting the nonunion of the acute osteoporotic vertebral compression fracture following low energy injuries by quantifying vertebral marrow fat fraction on t2 weighted dixon sequences
topic fracture
magnetic resonance imaging
marrow fat fraction
nonunion
osteoporosis
url https://doi.org/10.1111/os.70098
work_keys_str_mv AT pengguogou predictingthenonunionoftheacuteosteoporoticvertebralcompressionfracturefollowinglowenergyinjuriesbyquantifyingvertebralmarrowfatfractionont2weighteddixonsequences
AT ruiwang predictingthenonunionoftheacuteosteoporoticvertebralcompressionfracturefollowinglowenergyinjuriesbyquantifyingvertebralmarrowfatfractionont2weighteddixonsequences
AT zhihuizhao predictingthenonunionoftheacuteosteoporoticvertebralcompressionfracturefollowinglowenergyinjuriesbyquantifyingvertebralmarrowfatfractionont2weighteddixonsequences
AT yunguowang predictingthenonunionoftheacuteosteoporoticvertebralcompressionfracturefollowinglowenergyinjuriesbyquantifyingvertebralmarrowfatfractionont2weighteddixonsequences
AT yuanxue predictingthenonunionoftheacuteosteoporoticvertebralcompressionfracturefollowinglowenergyinjuriesbyquantifyingvertebralmarrowfatfractionont2weighteddixonsequences