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【medical-news】外周血管CTA检查费用优于MRA
外周血管CTA检查费用优于MRA
Multidetector-row CT angiography has the potential to be cost-effective for evaluating patients with intermittent claudication, according to researchers from the Netherlands and the U.S.
根据荷兰和美国的研究，在检查间歇性跛行方面，多排螺旋CT血管造影具有更好的性价比。
Investigators from booth University Medical Center Rotterdam and Harvard Medical School used a decision model to compare the societal cost-effectiveness of CTA with that of gadolinium-enhanced MRA. Main outcome measures were quality-adjusted life years (QALYs) and lifetime costs. The base evaluation used 60-year-old men with severe intermittent claudication and an assumed incremental cost-effectiveness threshold of $100,000 per QALY.
来自Rotterdam大学医学中心和哈佛医学院的研究者采用了决策模型来比较CTA和钆增强MRA的性价比。主要的评价指标包括经过校正的生存年数和总支出。本研究采用60的间歇跛行病例，假设每人的总支出性价比阈值为100000美金。
The study revealed that a specific set of targets will allow a CTA workup to compete cost-effectively with an MRA workup for patients suffering from intermittent claudication caused by significant stenosis.
该研究显示，对于血管狭窄引起的间歇跛行，CTA的性价比要优于MRA。
In the minimally invasive treatment scenario (angioplasty), cost-effectiveness was equivalent for CTA and MRA if CTA cost $420, its sensitivity to detect significant stenosis was 90%, and no more than 20% of patients required additional workup owing to equivocal CTA results. In 1997, a CTA exam cost $237, the authors said.
如果需要进行微创手术，且CTA定价420美金，CTA和MRA的性价比相当，CTA检测狭窄的敏感性是90%，不到20%的病人因为CT经过不明确需要进一步检查。在1997年，CTA检查费用是237美元。
If CTA cost $300 or less and had a sensitivity of at least 85%, it would still be cost-effective compared with MRA, even if up to 35% of patients needed additional workup, said Karen Visser, Ph.D, a postdoctoral fellow at Rotterdam when the trial was conducted.
如果CTA费用低于300美金，敏感性＞85%，假设35%的病人需要进一步检查，它的性价比也高于MRA。
CTA is simple to perform, fast, and quickly becoming widely available, according to Visser. Preliminary results of CTA for the workup of patients with peripheral arterial disease show a high diagnostic accuracy and sensitivity close to the study's estimated target value of 85%.
CTA易于操作，快速，应用广泛。初步研究证明周边血管病变CTA诊断准确率和敏感性都很高，接近预期的85%。
In the more invasive treatment scenario (bypass surgery), cost-effectiveness of CTA would be equivalent to MRA if the cost was $673 and sensitivity 95%, and no more than 20% of the patients required further workup with digital subtraction angiography.
如果需要进行大手术（搭桥），若CTA的敏感性达到95%且花费约673美元时，CTA与MRA的性价比相当，不到20%的病人需要DSA进一步检查。
In order for CTA to remain cost-effective in this scenario at a cost of $300, sensitivity would have to be higher than 94% and no more than 20% of patients could be referred for further DSA workup.
如果此时CTA保持性价比，需要花费控制在300美元，敏感性高于94%，不到20%的病人需要DSA进一步检查。
"Calculations of this kind can help focus not only the development of new modalities for the diagnostic workup of peripheral arterial disease, but also the development of new technologies in healthcare in general," the authors said.
作者说：此类计算不但有助于发展周边血管病变的新检查方法，也有助于新技术在所有医疗领域的应用。
The researchers are currently running a randomized clinical trial comparing CTA and MRA in a practical setting, Visser said.
研究者正在进行随机临床实验，比较实际应用过程中，CTA和MRA之间的优势差别。 看完今天发布的三个编译，基本上对于外周血管的影像学检查有了一个初步了解。
关于超声：在我实习的时候，和带教仪器做病人末端肢体的血流多普勒，测血流速度，不过不是学B超的，加上当时复习考硕，所以印象不深刻。
关于CTA：硕士课题单位的16层螺旋CT，做下肢血管从恰动脉开始，一直做到足背动脉，分两个期，一个期做动脉，一个期做静脉。主要还是糖尿病病人做得多，因为糖尿病病人小血管损害，末端循环不好。
关于MRA：在我研二研三的时候，在另一家单位做磁共振课题，机器比较好，做下肢血管MRA较多，主要还是血管炎，狭窄性病变，大部分是糖尿病。如果从吃线的角度将，MRA当然好，如果从成像质量上看，两者基本差不多。而且磁共振没有一个球管寿命问题。便于做动态扫描。
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作者:admin@医学,生命科学 2010-10-03 05:11
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