UNLABELLED: Osteoporosis is related to changes in vertebral bone marrow tissues, which can be detected by MRI. A novel MRI scoring method based on routine T1 and T2 sequences has been developed and demonstrated capabilities in detecting osteoporosis and discriminating vertebral fractures. The scoring method may provide an alternative tool other than BMD measurement for broad, opportunistic use in clinics. PURPOSE: As a routinely used radiation-free modality at the spine, magnetic resonance imaging (MRI) is promising to assess osteoporosis because it can detect age- or osteoporosis-related changes in bone marrow tissues. Here, we proposed a new MRI scoring method using the patient's low-back subcutaneous fat and cerebrospinal fluid as reference controls on routine T1 and T2 sequences, respectively, to indicate proton-rich changes in vertebrae for assessing osteoporosis and vertebral fractures. METHODS: The study included 60 female patients (64.1 ± 15.9 years) who underwent both MRI and quantitative computed tomography (QCT) at spine. T1-based F-score RESULTS: The F-score CONCLUSION: A new MRI scoring method based on routine T1 and T2 sequences has been developed and demonstrated improved abilities in detecting osteoporosis and discriminating vertebral fractures over VBQ and SNR.