Ruwe P A, Wright J, Randall R L, Lynch J K, Jokl P, McCarthy S
Department of Orthopedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06510.
Radiology. 1992 May;183(2):335-9. doi: 10.1148/radiology.183.2.1561332.
A study was performed to determine whether magnetic resonance (MR) imaging is cost-effective and reduces the need for diagnostic arthroscopy of the knee. During a 9-month period, 103 consecutive patients with knee injury that justified diagnostic arthroscopy underwent MR imaging. The MR images were interpreted by means of consensus of three radiologists and reviewed with the referring sports medicine orthopedists. After the examination, 44 patients (42.7%) underwent immediate arthroscopy. The 59 other patients (57.3%) did not undergo arthroscopy; follow-up was performed in 55 of these 59 patients (93%) at a mean of 22 months. The outcome was successful in 49 of 55 patients (89%); 40 patients had normal function and no limitation in activity, six patients with chronic injury of the anterior cruciate ligament underwent reconstruction, and three patients underwent arthroscopy with negative findings. Without the use of MR imaging, all patients in this study would have undergone diagnostic arthroscopy. Because of the diagnoses based on MR images, 53 patients (51.4%) avoided a potentially unnecessary diagnostic arthroscopy, and, as a result, the net savings was $103,700 in the 103 patients.
开展了一项研究，以确定磁共振（MR）成像是否具有成本效益以及是否能减少膝关节诊断性关节镜检查的必要性。在9个月的时间里，103例因膝关节损伤而有理由接受诊断性关节镜检查的连续患者接受了MR成像。MR图像由三位放射科医生共同解读，并与转诊的运动医学骨科医生进行了复查。检查后，44例患者（42.7%）立即接受了关节镜检查。另外59例患者（57.3%）未接受关节镜检查；这59例患者中有55例（93%）进行了平均为期22个月的随访。55例患者中有49例（89%）结果良好；40例患者功能正常且活动无受限，6例前交叉韧带慢性损伤患者接受了重建手术，3例患者接受了关节镜检查但结果为阴性。若不使用MR成像，本研究中的所有患者都将接受诊断性关节镜检查。基于MR图像做出的诊断，53例患者（51.4%）避免了可能不必要的诊断性关节镜检查，结果，103例患者共节省了103,700美元。
