Skeletal radiology · 2026
Regional variation in vertebral bone marrow adiposity: a population-based atlas of age- and sex-specific patterns.
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Bach Ulf, Uslar Thomas, Fünning Charlotte, Tombak Guney, Frenes Katharina, Walter Joan, Gerber Philipp A, Beuschlein Felix, Konukoglu Ender, Frauenfelder Thomas, Erdil Ertunc, Ensle Falko
Аннотация
BACKGROUND: Bone marrow adipose tissue (BMAT) is a metabolically active fat depot implicated in skeletal aging and systemic metabolism. While chemical shift-encoding MRI enables noninvasive quantification of bone marrow fat fraction (BMFF), current knowledge of vertebral BMAT is largely limited to small cohorts or restricted anatomical regions.
PURPOSE: To characterize the spatial distribution of vertebral bone marrow fat fraction across the spine and determine region-specific associations with age and sex in a population-based cohort.
MATERIALS AND METHODS: In this retrospective study, MRI data from 82,920 UK Biobank participants recruited between 2006 and 2010 were analyzed. The baseline case subset (n = 81,318) had a mean age of 54.8 ± 7.6 years, and 42,113/81,318 (51.8%) were female. Automated vertebral body segmentation enabled voxel-wise BMFF quantification using Dixon MRI. Vertebra- and region-level BMFF metrics were derived. Associations with age and sex were assessed using region-specific linear regression.
RESULTS: Vertebral BMAT demonstrated a non-linear cranio-caudal pattern. Mean BMFF was ~ 39% in the cervical, ~ 55% in the thoracic, ~ 45% in the lumbar spine, and ~ 70% in the sacrum. BMAT increased with age in all regions (all p < 0.001; increase per decade: cervical 3.33%, thoracic 3.41%, lumbar 2.95%, sacral 3.83%). Females exhibited higher BMFF than males across all regions (all p < 0.001). The overall spatial pattern remained consistent across age groups and sexes.
CONCLUSION: Vertebral BMAT exhibits a structured, non-linear spatial distribution with region-specific age- and sex-dependent patterns. This population-based atlas provides normative reference data supporting region-specific BMAT assessment in skeletal and metabolic disease.
PURPOSE: To characterize the spatial distribution of vertebral bone marrow fat fraction across the spine and determine region-specific associations with age and sex in a population-based cohort.
MATERIALS AND METHODS: In this retrospective study, MRI data from 82,920 UK Biobank participants recruited between 2006 and 2010 were analyzed. The baseline case subset (n = 81,318) had a mean age of 54.8 ± 7.6 years, and 42,113/81,318 (51.8%) were female. Automated vertebral body segmentation enabled voxel-wise BMFF quantification using Dixon MRI. Vertebra- and region-level BMFF metrics were derived. Associations with age and sex were assessed using region-specific linear regression.
RESULTS: Vertebral BMAT demonstrated a non-linear cranio-caudal pattern. Mean BMFF was ~ 39% in the cervical, ~ 55% in the thoracic, ~ 45% in the lumbar spine, and ~ 70% in the sacrum. BMAT increased with age in all regions (all p < 0.001; increase per decade: cervical 3.33%, thoracic 3.41%, lumbar 2.95%, sacral 3.83%). Females exhibited higher BMFF than males across all regions (all p < 0.001). The overall spatial pattern remained consistent across age groups and sexes.
CONCLUSION: Vertebral BMAT exhibits a structured, non-linear spatial distribution with region-specific age- and sex-dependent patterns. This population-based atlas provides normative reference data supporting region-specific BMAT assessment in skeletal and metabolic disease.