Some debate exists on the optimal imaging method for diagnostic confirmation of fracture in patients with suspect scaphoid injury. This particular study tested the hypothesis that CT and MRI have the same diagnostic performance characteristics for the diagnosis of scaphoid fractures. Thirty-four consecutive patients with suspected scaphoid fracture underwent CT and MRI within ten days after injury to the wrist. All patients also had six-weeks follow-up x-rays with scaphoid specific views, which was considered the reference standard.
The results of the study found six true fractures on six-weeks follow-up radiographs. CT and MRI found five and 7 true fractures, respectively. CT had a sensitivity of 67%, specificity of 96%, and accuracy of 91%. MRI had sensitivity of 67%, specificity of 89%, and accuracy of 85%. The article found no statistically significant differences between CT and MRI.
The numbers reported in this article appear to be lower than what has been reported in non-comparison cohort studies. Also in several other studies, MRI has performed better than CT. The article agrees with other studies in that CT and MRI are better at excluding scaphoid fractures than confirming them. Some researchers may argue that MRI is better for the diagnosis of scaphoid fractures, but CT is better for surgical planning and understanding the anatomy of scaphoid fractures. More comparison studies are needed on this subject, but from the data in this study, CT and MRI do appear to give similar results in diagnosing suspected scaphoid fractures.