论著 Original Article

早期股骨头坏死影像学诊断的成本效益分析

Published at: 2015年第35卷第1期

金磊 1 , 胡柯嘉 2 , 吴永伟 1 , 芮永军 1 , 陆尧 1 , 孔友谊 1
1 苏州大学附属无锡市第九人民医院创伤骨科,江苏 无锡 214062
2 复旦大学附属华山医院显微外科,上海 200040
通讯作者 永伟 吴 Email: wxswk_gk@hotmail.com
DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2015.01.016
基金:

摘要

目的:探讨早期成人股骨头缺血坏死(femoral head necrosis,FHN)的MR、CT、SPECT和X线平 片4种影像学检查的成本效益比,寻找较好的成本效益的检查方法。方法:分析和总结82例129 髋随访和病理证实或具有典型影像学表现的早期(ARCO I~II期)成人FHN病人的髋关节影像学资 料。全部病例均同期行MRI、CT、单光子发射计算机体层摄影(single photon emission computed tomography,SPECT)和X线平片检查。采用成本效果分析法(cost-effectiveness analysis,CEA),对 4种影像学检查诊断效率研究中的数据进行分析,比较其正确检出费用(cost of accurate diagnosis, CAD)。结果:4种影像学检查方法的诊断差异有显著性意义。早期诊断成人FHN的检出费用最低 的是X线平片,对于X线平片确诊组和诊断可疑组,MRI检出费用并无太大变化,而CT费用最低; 对于X线平片诊断阴性组,MRI 诊断的敏感性和准确性综合比较高于CT 和SPECT,且诊断费用也 最低。结论:X线适合早期股骨头坏死的筛选,而MRI诊断的敏感性和准确性综合比较高于CT和 SPECT,而且应当作为X线诊断阴性的可疑股骨头坏死患者进一步诊断的首选。


Cost-effective analysis for the imaging diagnosis of early femoral head necrosis

Abstract

Objective: To evaluate the cost-effective analysis of MRI, CT, SPECT and X-ray in the adult early femoral head necrosis, and investigate the more effective way for diagnosis. Methods: Eighty-two cases (129 hips) with early FHN in adult (ARCO stage I~II) proved by follow-up studies, pathology, or typical imageologic manifestations were analyzed. All the patients underwent MRI, CT, SPECT and X-ray in the same period. With cost-effective analysis, compare the cost of accurate diagnosis (CAD) of the 4 diagnosis. Results: There were statistical differences in diagnosing early FHN in adults by MRI, CT, SPECT and X-ray. The smallest cost for accurate diagnosis was X-ray. When X-ray made a certain or suspicious diagnosis, the diagnosis cost of MRI was nearly the same, CT had the smallest CAD. When X-ray diagnosed negative, MRI was the most sensitive and accurately way, also had the smallest CAD. Conclusion: X-ray can be used to screen early femoral head necrosis, MRI is the most sensitive and accurately way, especially the first choice of previous diagnosis when X-ray’s result is negative.


comments powered by Disqus

全文

引用

引用本文: 磊 金, 柯嘉 胡, 永伟 吴, 永军 芮, 尧 陆, 友谊 孔. 早期股骨头坏死影像学诊断的成本效益分析[J]. 临床与病理杂志, 2015, 35(1): 59-64.
Cite this article as: JIN Lei, HU Kejia, WU Yongwei, RUI Yongjun, LU Yao, KONG Youyi . Cost-effective analysis for the imaging diagnosis of early femoral head necrosis[J]. Journal of Clinical and Pathological Research, 2015, 35(1): 59-64.