Background: Osteoporotic vertebral fractures are a common and important consequence of osteoporosis and are identified by morphometry on a plain lateral spine radiograph. A new method of vertebral morphometry using images acquired on a dual energy X-ray absorptiometry scanner (DEXA morphometry) has recently been developed. The purpose of this study was to compare the diagnostic value of DEXA morphometry in osteoporotic vertebral fractures with that of radiographic morphometry in Korean women.
Methods: Fifty-six postmenopausal women with osteoporotic vertebral fractures were included in this study. Plain lateral radiographs of the thoracic and lumbar vertebrae were taken and radiographic morphometry with 6 point placement and caliper measurements were done. DEXA morphometry using Lunar Expert (Madison, WI) was also performed in the same patients from T6 to L4. Osteoporotic vertebral fractures were defined by any deformity of more than 3 standard deviation from the mean in radiographic and DEXA morphometry. Agreement of fracture identification and reproducibility between radiographic morphometry and DEXA morphometry were compared using Kappa statistics.
Results: The mean coefficient of variation of inter and intra-observer variability for radiographic morphometry were 1.5%, 2.4%, respectively and those of DEXA morphometry were 0.8%, 3.2%, respectively. Agreement of fracture identification between the two methods was excellent (Kappa= 0.896).
Conclusion: Fracture identification using DEXA morphometry showed excellent agreement with that of radiographic morphometry and both methods showed relatively the same reproducibility.