PDF(Pubmed)
Abstract：
Identifying the full scope of pelvic fracture patterns in older adults has gained clinical importance since the last decennium. CT is recommended as the golden standard; however, MRI has even greater diagnostic accuracy. Dual energy computed tomography (DECT) is a new and promising imaging technique, but the diagnostic accuracy in the context of pelvic fragility fractures (FFPs) has not been widely established. The aim was to provide insight into the diagnostic accuracy of different imaging techniques and the relevance for clinical practice. A systematic search was performed in the PubMed database. All studies that reported on CT, MRI or DECT imaging techniques in older adults who suffered a pelvic fracture were reviewed and, if relevant, included. Eight articles were included. In up to 54% of the patients, additional fractures were found on MRI compared to CT, and in up to 57% of the patients on DECT. The sensitivity of DECT for posterior pelvic fracture detection was similar to MRI. All patients without fractures on CT appeared to have posterior fractures on MRI. After additional MRI, 40% of the patients had a change of classification. DECT and MRI showed very similar results in terms of diagnostic accuracy. Over a third of all patients appear to have a more severe fracture classification after MRI, the majority changing to Rommens type 4. However, in only a few patients who changed of fracture classification, a change of therapy was advised. This review suggests that MRI and DECT scans are superior in diagnosing FFPs.
摘要：
自上一个十年以来，确定老年人骨盆骨折类型的全部范围已具有临床重要性。CT被推荐为黄金标准；然而，MRI具有更高的诊断准确性。双能计算机断层扫描(DECT)是一种新的、有前途的成像技术,但骨盆脆性骨折(FFP)的诊断准确性尚未得到广泛证实.目的是深入了解不同成像技术的诊断准确性以及与临床实践的相关性。在PubMed数据库中进行了系统搜索。所有关于CT的研究,MRI或DECT成像技术在老年人遭受骨盆骨折的审查，如果相关，包括。其中有8篇文章。在高达54%的患者中，与CT相比，MRI上发现了额外的骨折，高达57％的DECT患者。DECT检测骨盆后骨折的敏感性与MRI相似。所有在CT上没有骨折的患者在MRI上似乎都有后部骨折。额外MRI后,40%的患者有分类变更。DECT和MRI在诊断准确性方面显示出非常相似的结果。超过三分之一的患者在MRI后似乎有更严重的骨折分类，大多数改为Rommens4型。然而,只有少数改变骨折分类的患者，建议改变治疗方式.这篇综述表明，MRI和DECT扫描在诊断FFP方面具有优势。
