Moller Jakob M, Larsen Lone, Bovin Jan, Lausten Gunnar S, Hasselqvist Maria, Jensen Claus Munk, Ropke Ian, Thomsen Henrik S
Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev, Herlev Ringvej 75, DK-2730 Herlev, Denmark.
Acad Radiol. 2004 Jul;11(7):724-8. doi: 10.1016/j.acra.2004.03.049.
To investigate whether magnetic resonance imaging (MRI) radiographers are able to evaluate MRI examinations with regard to scaphoid fractures to save patients unnecessary immobilization and clinical and radiographic examinations, and to reduce the costs for the hospital as well as society in general.
Over a 1-year period 224 consecutive patients with a suspected clinical scaphoid fracture but negative radiography were referred for MRI and examined within 11 hours. The MR images were primarily evaluated by the MRI radiographer on duty. Other fractures and bone edema were not reported because these were not part of the work-up protocol agreed upon by the radiology and the orthopedic departments. The following weekday a final report was provided by a radiologist. For the economical analysis the official price-list for Danish hospital service was used.
The MRI radiographers reported 43 scaphoid fractures, whereas the radiologist ultimately diagnosed only 36 scaphoid fractures (16.1% of patients) (sensitivity, 100%; specificity, 96.3%). Six of the seven false-positive fractures occurred in patients with edema of the scaphoid. The seventh false-positive was a fracture of the capitate. The hospital saved at least 20,000 and the social care system 70.000.
It is possible to provide an acute MRI service to patients with clinically suspected fracture of the scaphoid and a normal plain radiograph. The MR images can be primarily read by sufficiently trained MR radiographers. This new work-up protocol reduces the cost for society.
研究磁共振成像（MRI）技师能否对舟状骨骨折的MRI检查进行评估，从而避免患者不必要的固定以及临床和放射学检查，并降低医院乃至整个社会的成本。
在1年的时间里，连续224例临床疑似舟状骨骨折但X线摄影呈阴性的患者被转诊进行MRI检查，并在11小时内完成检查。MR图像主要由当班的MRI技师进行评估。未报告其他骨折和骨水肿情况，因为这些不属于放射科和骨科商定的检查方案的一部分。在接下来的工作日，由放射科医生提供最终报告。经济分析采用丹麦医院服务的官方价格表。
MRI技师报告了43例舟状骨骨折，而放射科医生最终仅诊断出36例舟状骨骨折（占患者的16.1%）（敏感性为100%；特异性为96.3%）。7例假阳性骨折中有6例发生在舟状骨水肿的患者中。第7例假阳性是头状骨骨折。医院至少节省了20,000，社会护理系统节省了70,000。
为临床疑似舟状骨骨折且平片正常的患者提供急性MRI服务是可行的。MR图像可由训练有素的MRI技师初步解读。这种新的检查方案降低了社会成本。
