Ua hōʻike ʻia kahi noiʻi i paʻi ʻia nei ma ka American Journal of Radiology e hiki paha iā MRI ke ʻano hana kiʻi kūpono loa no ka loiloi ʻana i nā maʻi e hōʻike ana i ka ʻoihana pilikia me ka dizziness, ʻoiai ke noʻonoʻo nei i nā kumukūʻai ma hope.
Ua hōʻike ʻia e kahi hui i alakaʻi ʻia e Long Tu, MD, PhD, mai ke Kula Lapaʻau ʻo Yale ma New Haven, CT, he hiki i nā ʻike ke hoʻomaikaʻi i ka mālama ʻana i nā mea maʻi ma o ka ʻike ʻana i nā hahau kumu. Ua ʻike pū lākou ʻo ka dizziness ka hōʻailona o ka hahau ʻana i pili pinepine ʻia i kahi hōʻailona i hala ʻole.
Ma kahi o 4% o nā kipa ʻana i nā keʻena pilikia ma ʻAmelika Hui Pū ʻIa e hopena mai ka dizziness. ʻOiai ʻoi aku ka liʻiliʻi ma mua o 5% o kēia mau hihia e pili ana i kahi hahau kumu, he mea nui e kāpae iā ia. Hoʻohana ʻia ka CT poʻo non-contrast a me ke poʻo a me ka ʻāʻī CT angiography (CTA) e ʻike i ka hahau, akā ua kaupalena ʻia ko lākou ʻike, e kū ana ma 23% a me 42%. ʻO MRI, ma ka ʻaoʻao ʻē aʻe, e haʻaheo ana i kahi ʻike kiʻekiʻe ma 80%, a ʻo nā protocol MRI kūikawā e like me ka hoʻonā kiʻekiʻe, multiplanar DWI acquisitions e like me ka hoʻokō ʻana i kahi helu ʻike kiʻekiʻe o 95%.
Eia naʻe, ua kūpono anei ke kumukūʻai i hoʻohui ʻia o ka MRI e kona mau pono? Ua nānā ʻo Tu a me kāna hui i ke kumukūʻai kūpono o nā ʻano neuroimaging ʻehā like ʻole no ka loiloi ʻana i nā maʻi i hōʻea i ka ʻoihana pilikia me ka dizziness: ke kiʻi poʻo CT non-contrast, ke poʻo a me ka ʻāʻī CT angiography, ka MRI lolo maʻamau, a me ka MRI holomua (e komo pū ana me ka multiplanar high-resolution DWI). Ua hana ka hui i kahi hoʻohālikelike o nā lilo lōʻihi a me nā hopena e pili ana me ka ʻike ʻana i ka hahau a me ka pale ʻana i ka lua.
Eia nā hopena i loaʻa iā Tu a me kāna mau hoa hana:
Ua hōʻoia ʻia ka MRI kūikawā ʻo ia ke ʻano hana kūpono loa i ke kumukūʻai, e loaʻa ana nā QALY kiʻekiʻe loa ma ke kumukūʻai hou aʻe o $13,477 a me 0.48 QALYs ʻoi aku ka nui ma mua o ka CT poʻo ʻaʻohe contrast.
Ma hope o kēia, ua hōʻike ka MRI maʻamau i ka pono olakino kiʻekiʻe aʻe, me ka hoʻonui ʻia o ke kumukūʻai o $6,756 a me 0.25 QALYs, ʻoiai ua loaʻa iā CTA kahi kumukūʻai hou o $3,952 no 0.13 QALYs.
Ua ʻike ʻia he ʻoi aku ka maikaʻi o ke kumukūʻai o ka MRI kuʻuna ma mua o CTA, me ka emi ʻana o ke kumukūʻai ma lalo o $30,000 no kēlā me kēia QALY.
Ua hōʻike pū ka loiloi he ʻoi aku ka maikaʻi o ke kumukūʻai o ka MRI kūikawā ma mua o ka MRI maʻamau, ʻo ia hoʻi, ʻoi aku ka maikaʻi o ke kumukūʻai ma mua o ka CTA. I ka hoʻohālikelike ʻana i nā koho kiʻi āpau, ʻo ka CT noncontrast wale nō ka mea i hōʻike i ka pōmaikaʻi haʻahaʻa loa.
ʻOiai ke kiʻekiʻe o ke kumukūʻai hoʻonui o MRI i hoʻohālikelike ʻia me CT a i ʻole CTA, ua hōʻike ka hui i kona kikoʻī a me ka hiki ke hōʻemi i nā kumukūʻai ma hope ma o ka hoʻokō ʻana i nā QALY nui aʻe.
Hauʻoli wau e kaʻana like ua lilo ʻo LnkMed i hoʻokahi o nā mea hana hilinaʻi loa i ke kiʻi lapaʻau. Hāʻawi mākou i kahi laulā piha o nā hoʻonā lapaʻau a me nā lawelawe i ke kiʻi diagnostic. Loaʻa iā mākou ʻelua mau kahua, aia nā mea ʻelua ma shenzhen, ka ʻāpana ʻo pingshan. ʻO kekahi e hana i ka mea hoʻokomo media contrat, meʻŌnaehana inikini hoʻokahi CT,ʻŌnaehana inikini poʻo pālua CT, ʻŌnaehana inikini MRIa meʻŌnaehana inikini angiographyA ʻo kekahi, ʻo ia ka hana ʻana i ka syringe a me nā ʻōmole.
Makemake mākou e lilo i mea hoʻolako huahana kiʻi lapaʻau hilinaʻi nou.
Ka manawa hoʻouna: Dec-15-2023
