Dabas Muath M, Alameri Abrar D, Mohamed Noor M, Mahmood Rabia, Kim Dong Hwi, Samreen Mubushra, Kim Ji Woo, Shehryar Abdullah, Gyambrah Samantha, Bedros Adees W, Rehman Abdur, Khan Safdar
Surgery, The University of Jordan, Amman, JOR.
Medicine, Rashid Hospital, Dubai, ARE.
Cureus. 2024 Oct 22;16(10):e72086. doi: 10.7759/cureus.72086. eCollection 2024 Oct.
Traumatic brain injury (TBI) is a leading cause of mortality and long-term disability worldwide, and accurate imaging is essential for effective diagnosis, management, and prognosis. This systematic review evaluates the diagnostic capabilities of magnetic resonance imaging (MRI) compared to computed tomography (CT) in assessing TBI across various severities. Through a comprehensive search strategy, studies were selected that directly compared MRI and CT in TBI diagnosis, incorporating advanced MRI techniques such as susceptibility-weighted imaging and fluid-attenuated inversion recovery. The findings confirm that while CT is indispensable in acute settings for the rapid identification of life-threatening conditions such as hemorrhage and skull fractures, MRI offers superior sensitivity for detecting subtle lesions, microbleeds, and diffuse axonal injury. MRI techniques, including magnetic resonance spectroscopy, demonstrated the ability to detect metabolic changes in normal-appearing white matter, which were predictive of long-term neurological outcomes. Additionally, the integration of biomarkers, such as imaging modalities, showed the potential to improve diagnostic accuracy and reduce unnecessary CT scans. Despite the limitations related to study heterogeneity and the exclusion of non-English studies, this review underscores the complementary roles of MRI and CT in TBI management, suggesting that a combined approach can provide the most thorough assessment and improve patient outcomes. Future research should focus on large-scale trials to further refine the clinical application of these imaging modalities.
创伤性脑损伤（TBI）是全球范围内导致死亡和长期残疾的主要原因之一，准确的影像学检查对于有效的诊断、治疗和预后评估至关重要。本系统评价比较了磁共振成像（MRI）与计算机断层扫描（CT）在评估不同严重程度TBI时的诊断能力。通过全面的检索策略，选取了直接比较MRI和CT在TBI诊断中的研究，纳入了诸如磁敏感加权成像和液体衰减反转恢复等先进的MRI技术。研究结果证实，虽然CT在急性情况下对于快速识别危及生命的情况（如出血和颅骨骨折）不可或缺，但MRI在检测细微病变、微出血和弥漫性轴索损伤方面具有更高的敏感性。包括磁共振波谱在内的MRI技术显示出能够检测正常外观白质中的代谢变化，这些变化可预测长期神经学预后。此外，生物标志物（如成像模式）的整合显示出提高诊断准确性和减少不必要CT扫描的潜力。尽管存在与研究异质性相关的局限性以及排除了非英语研究，但本综述强调了MRI和CT在TBI管理中的互补作用，表明联合应用可提供最全面的评估并改善患者预后。未来的研究应聚焦于大规模试验，以进一步完善这些成像模式的临床应用。
