Comparative Efficacy of MRI and CT in Traumatic Brain Injury: A Systematic Review

Traumatic brain injury (TBI) is a leading cause of mortality and long-term disability worldwide, and accurate imaging is essential for effective diagnosis, management, and prognosis. This systematic review evaluates the diagnostic capabilities of magnetic resonance imaging (MRI) compared to computed tomography (CT) in assessing TBI across various severities. Through a comprehensive search strategy, studies were selected that directly compared MRI and CT in TBI diagnosis, incorporating advanced MRI techniques such as susceptibility-weighted imaging and fluid-attenuated inversion recovery. The findings confirm that while CT is indispensable in acute settings for the rapid identification of life-threatening conditions such as hemorrhage and skull fractures, MRI offers superior sensitivity for detecting subtle lesions, microbleeds, and diffuse axonal injury. MRI techniques, including magnetic resonance spectroscopy, demonstrated the ability to detect metabolic changes in normal-appearing white matter, which were predictive of long-term neurological outcomes. Additionally, the integration of biomarkers, such as imaging modalities, showed the potential to improve diagnostic accuracy and reduce unnecessary CT scans. Despite the limitations related to study heterogeneity and the exclusion of non-English studies, this review underscores the complementary roles of MRI and CT in TBI management, suggesting that a combined approach can provide the most thorough assessment and improve patient outcomes. Future research should focus on large-scale trials to further refine the clinical application of these imaging modalities.