Diagnostic Accuracy of MRI in Detecting Microfractures in Polytrauma Patients

Abstract

The research paper assesses the diagnostic validity of Magnetic Resonance Imaging (MRI) in detecting microfractures on polytrauma patients, which is one of the clinical issues contributing to delayed therapy when fractures are still occult on other imaging modalities. The study employed a mixed-method experimental study, which compared the results of MRI and a composite reference standard, high-resolution computed tomography and intraoperative observations. A wide range of MRI sequences was used to determine changes in marrow edema, disruption of trabecular structure, and cortical changes: T1, T2, STIR, and gradient-echo. The quantitative findings presented that MRI was highly sensitive to identify marrow-based microfractures, especially in the areas of the anatomy rich in the trabecular structures, but denser cortical structures had higher patterns of false-negative. Specificity depended on the parameters of sequence, with the STIR sequence and the gradient- echo sequence being the most suitable structures to provide the best contrast. Trends of predictive value, and inter-rater reliability assessments also supported the strong performance of MRI, and significant consensus between radiologists was achieved when standardized reporting criteria were employed. The results of regression analysis showed that the intensity of edema and clinical symptom severity were significantly detectable, and the use of clinical markers in the imaging workflow is justified. All in all, the study confirms that MRI is a necessary diagnostic method in trauma cases, especially in case early detection can affect treatment planning, morbidity, and long-term complications. These results underpin the necessity of streamlined multi-sequence MRI sequences and point to the opportunities of utilizing advanced imaging analytics to improve microfracture imaging in different trauma groups.