The Role of MRI and CT Scan in Classification and Management of Pelvic Fractures: A Systematic Review

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.