[听性脑干反应（ABR）和磁共振成像（MRI）在听神经瘤筛查中的作用及成本效益分析。151例回顾性研究]

[Contribution and Cost-Effectiveness of ABR and MRI in Acoustic Neuroma screening. Retrospective Study of 151 Cases].

作者信息

Portier F, Herman Ph, Lot G, Tran Ba Huy P

机构信息

Service d'ORL et de Chirurgie Cervico-faciale, Hôpital Lariboisière, 2, rue A. Paré 75010 Paris, France.

出版信息

Ann Otolaryngol Chir Cervicofac. 2002 Apr;119(2):67-72.

PMID:12015490

Abstract

The aim of this study was to retrospectively assess during two periods (1991-1995 and 1996-2000) if MRI spreading had changed: (1) private ENT physicians screening habits; (2) the average tumor size at the time of diagnosis and the diagnostic delay of acoustic neuroma; and (3) the cost of acoustic neuroma diagnosis. In addition, the sensibility of each diagnostic test was calculated on 151 tumors. Our results show no significant change neither in the screening strategy (except a mild decrease in CT-scan utilization) nor in the tumor size, diagnostic delay or diagnostic cost between the two periods. Even if MRI is the gold standard for acoustic neuroma diagnosis, our 86%-sensibility of ABR, increased to 99% if combined with stapedial reflex and caloric test may still incline to use ABR in selected cases.

摘要

本研究的目的是回顾性评估在两个时期（1991 - 1995年和1996 - 2000年）MRI普及是否产生了变化：（1）私人耳鼻喉科医生的筛查习惯；（2）诊断时听神经瘤的平均肿瘤大小和诊断延迟；（3）听神经瘤诊断的成本。此外，还对151个肿瘤计算了每种诊断测试的敏感性。我们的结果显示，两个时期之间在筛查策略（CT扫描使用率略有下降除外）、肿瘤大小、诊断延迟或诊断成本方面均无显著变化。即使MRI是听神经瘤诊断的金标准，但我们的ABR敏感性为86%，如果与镫骨肌反射和冷热试验相结合则可提高到99%，这可能仍倾向于在某些病例中使用ABR。