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• Clinical Article •
The value of a multi-parameter imaging-based nomogram model in assessing the risk of vertebral compression fractures in postmenopausal women
WANG Wenjuan  ZOU Yuefen  LIU Xiaofeng  HU Lei  ZHU Haoyu  CHEN Yaodong 

DOI:10.12015/issn.1674-8034.2026.05.015.


[Abstract] Objective To establish a nomogram risk model to evaluate its practical utility in assessing the risk of vertebral compression fractures in postmenopausal women by using multiparametric imaging indices derived from quantitative computed tomography (QCT), conventional magnetic resonance imaging (MRI) sequences, and functional MRI sequences.Materials and Methods From March 2025 to January 2026, recruitment of postmenopausal women presenting with lumbar spine disorders at the Orthopedic Department of Chizhou People's Hospital. Clinical and imaging data were collected, and patients were classified into a fracture group (n = 53) and a non-fracture group (n = 51) based on clinical presentation and imaging findings. For patients in the fracture group, measurements were taken from vertebrae that had not sustained fractures. The Mann-Whitney U test or independent samples t-test was used to analyze differences between groups. This study used a stepwise regression method to conduct a binary logistic regression analysis to identify independent factors for vertebral compression fractures in postmenopausal women. A nomogram risk model based on independent influencing factors was constructed using R4.5.2. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was employed to assess the model's discriminatory ability, the calibration curve was used to evaluate its accuracy, and the decision curve analysis (DCA) curve was applied to test its clinical decision-making utility. Additionally, internal validation was conducted to verify the model's stability.Results Intergroup comparisons revealed statistically significant differences in age, volumetric bone mineral density (vBMD), vertebral body quality (VBQ) score, fat fraction (FF), and proton density (PD) (P < 0.05). No statistically significant differences were observed in body mass index (BMI), T1 relaxation time, or T2 relaxation time between groups (P > 0.05). After step wise backward regression, the final model retained three independent factors: vBMD, VBQ score, and PD. Among these, vBMD was an independent protective factor against fracture (OR = 0.959, 95% CI: 0.935 to 0.984, P = 0.001), while VBQ scores (OR = 5.055, 95% CI: 1.324 to 19.291, P = 0.018) and PD (OR = 1.067, 95% CI: 1.008 to 1.130, P = 0.025) were independent risk factors. The AUC of the Nomogram risk model constructed based on the above three parameters was 0.891 (95% CI: 0.815 to 0.944), and its ability to distinguish risk was superior to that of vBMD (AUC = 0.829), the VBQ score (AUC = 0.830), and PD (AUC = 0.766), with P-values all < 0.05. The calibration curve indicated that the model performed well in identifying risk factors for vertebral compression fractures in postmenopausal women, and the DCA demonstrated that the model offers good clinical net benefit.Conclusions The study found that vBMD, VBQ scores, and PD are independent factors for vertebral compression fractures in postmenopausal women. The nomogram risk model developed based on these three parameters demonstrates good discriminatory performance and clinical utility, providing a new quantitative tool for assessing the risk of vertebral compression fractures in postmenopausal women.
[Keywords] postmenopausal women；vertebral compression fractures；factors；nomogram risk model；magnetic resonance imaging

WANG Wenjuan1   ZOU Yuefen2*   LIU Xiaofeng1   HU Lei1   ZHU Haoyu1   CHEN Yaodong1  

1 Department of Radiology, Chizhou People's Hospital, Chizhou 247100, China

2 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

Corresponding author: ZOU Y F, E-mail: zou_yf@163.com

Conflicts of interest   None.

Received  2026-02-02
Accepted  2026-05-08
DOI: 10.12015/issn.1674-8034.2026.05.015
DOI:10.12015/issn.1674-8034.2026.05.015.

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