Abstract
Background Magnetic resonance and computed tomography (MRI, CT) has been known to compare the
sensitivity for the detection of pelvic fractures with others. It is unclear whether
MRI imaging beyond CT leads to therapy change. The aim of our study is to determine
the information gained from MRI in the diagnosis of pelvic fractures and to reduce
the effects on the form of therapy.
Patients and Methods In a retrospective, clinical study, 31 patients with pelvic fracture and CT and MRI
imaging (median 81 ± 20 years, 22 female and 9 male) were examined. There was a classification
according to AO classification for adequate or FFP classification for inadequate fractures.
In addition, vascular, muscular, haematomatous and organic concomitant injuries as
well as bone marrow edema and additional secondary findings requiring evaluation were
evaluated. The type of therapy (conservative vs. surgical) and a possible type of
therapy change were documented for each patient. Exact test according to Fisher was
tested orienting.
Results Overall, MRI showed a greater fracture rate of pelvic fractures in 29% (n = 9) patients
than CT. Four type I fractures according to FFP classification were identified as
type II fractures and 4 type II fractures as type IV fractures. One type B1 fracture
according to AO classification was found to be C2 fracture on MRI. Fisherʼs Exact
Test found that the parameters “adequacy of trauma” and “fracture type change” by
MRI were p = 0.38. MRI showed a total of 82 concomitant injuries, CT 31. Overall,
MRI gained information in 75% (n = 24) of all patients examined. A change from conservative
to operative after MRI took place in 2 patients. No patient was surgically changed
from planned surgery to conservative. The extent to which MRI caused changes within
one form of therapy (conservative, operative) could not be determined retrospectively.
In 18% of patients with an inadequate fracture, however, according to the literature,
the treatment regimen would have
changed pro forma.
Conclusion In summary, it can be stated that the MRI in our study provided an information gain
in the case of adequate and inadequate pelvic fractures as well as their accompanying
injuries and that a possible therapeutic relevance of this information gain could
be obtained specially at the inadequate fractures showed.
Key words
pelvic fractures - fragility fractures - MRI - CT - classification
