Almansouri Dalal H, Elsherbini Ayat I, Alharthi Manal, ALotaibi Shatha, Alshehri Lamyaa
Radiologic Technology, Specialized Dental Center, Taif, SAU.
Radiology, Faculty of Medicine, Tanta Univerisity, Tanta, EGY.
Cureus. 2024 Jan 13;16(1):e52215. doi: 10.7759/cureus.52215. eCollection 2024 Jan.
The mortality risk for individuals with pelvic fractures ranges from 10% to 50%, depending on the severity of the bleeding and the presence of concurrent brain, thorax, and abdomen injuries. This systematic review aims to comprehensively investigate the role of MRI and CT in diagnosing and managing pelvic fractures. PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. The keywords "Pelvic fractures," "Diagnosis," "Computed tomography," "CT," "Magnetic resonance imaging," and "MRI" were converted into PubMed Mesh terms and used to find the relevant studies. Rayyan Qatar Computing Research Institute (QCRI) was employed throughout this comprehensive process. The systematic review included publications with full English text, available free articles, and human trials among adults. This review included 12 studies with 1,798 patients, and 935 (52%) of them were females. Two articles were prospective, and 10 articles were retrospective. In conclusion, the diagnosis and management of pelvic fractures require a tailored approach based on patient characteristics, injury mechanisms, and hemodynamic status. Because MRI detects a high number of concealed sacral fractures, it provides greater sensitivity and diagnostic validity in identifying acute pelvic fractures. Moreover, MRI is effective in diagnosing occult pelvic fractures and detecting soft tissue anomalies. However, MRI is unlikely to replace CT as the gold standard in the initial diagnosis of pelvic fractures; CT may also be preferable to MRI due to shorter emergency department (ED) time and the significant proportion of elderly patients who are contraindicated to MRI. Additionally, CT scanning aids in determining the need for emergent angiographic embolization and facilitates surgical planning.
骨盆骨折患者的死亡风险在10%至50%之间，这取决于出血的严重程度以及是否同时存在脑、胸和腹部损伤。本系统评价旨在全面研究MRI和CT在骨盆骨折诊断和管理中的作用。我们系统检索了PubMed、SCOPUS、Web of Science和ScienceDirect等数据库以查找相关文献。将关键词“骨盆骨折”“诊断”“计算机断层扫描”“CT”“磁共振成像”和“MRI”转换为PubMed医学主题词，用于查找相关研究。在整个综合过程中使用了卡塔尔计算研究所（QCRI）的Rayyan工具。该系统评价纳入了全文为英文的出版物、免费获取的文章以及成人中的人体试验。本评价纳入了12项研究，共1798例患者，其中935例（52%）为女性。2篇文章为前瞻性研究，10篇文章为回顾性研究。总之，骨盆骨折的诊断和管理需要根据患者特征、损伤机制和血流动力学状态采取量身定制的方法。由于MRI能检测出大量隐匿性骶骨骨折，因此在识别急性骨盆骨折方面具有更高的敏感性和诊断有效性。此外，MRI在诊断隐匿性骨盆骨折和检测软组织异常方面也很有效。然而，MRI不太可能取代CT成为骨盆骨折初始诊断的金标准；由于急诊科检查时间较短，且有相当比例的老年患者不适合进行MRI检查，CT可能比MRI更具优势。此外，CT扫描有助于确定是否需要紧急血管造影栓塞，并便于进行手术规划。
