Eikefjord E, Askildsen J E, Rørvik J
Department of Radiology, Haukeland University Hospital, Bergen, Norway.
Acta Radiol. 2008 Mar;49(2):222-9. doi: 10.1080/02841850701708304.
It is important to compare the cost and effectiveness of multidetector computed tomography (MDCT) and intravenous urography (IVU) to determine the most cost-effective alternative for the initial investigation of acute ureterolithiasis.
To analyze the task-specific variable costs combined with the diagnostic effect of MDCT and IVU for patients with acute flank pain, and to determine which is most cost effective.
119 patients with acute flank pain suggestive of stone disease (ureterolithiasis) were examined by both MDCT and IVU. Variable costs related to medical equipment, consumption material, equipment control, and personnel were calculated. The diagnostic effect was assessed.
The variable costs of MDCT versus IVU were EUR 32 and EUR 117, respectively. This significant difference was mainly due to savings in examination time, higher annual examination frequency, lower material costs, and no use of contrast media. As for diagnostic effect, MDCT proved considerably more accurate in the diagnosis of stone disease than IVU and markedly more accurate concerning differential diagnoses.
MDCT had lower differential costs and a higher capacity to determine correctly stone disease and differential diagnoses, as compared to IVU, in patients with acute flank pain. Consequently, MDCT is a dominant alternative to IVU when evaluated exclusively from a cost-effective perspective.
比较多排螺旋计算机断层扫描（MDCT）和静脉肾盂造影（IVU）的成本和有效性，对于确定急性输尿管结石初始检查最具成本效益的方法很重要。
分析MDCT和IVU针对急性腰痛患者的特定任务可变成本及其诊断效果，以确定哪种方法最具成本效益。
对119例疑似结石病（输尿管结石）的急性腰痛患者进行了MDCT和IVU检查。计算了与医疗设备、耗材、设备控制和人员相关的可变成本，并评估了诊断效果。
MDCT和IVU的可变成本分别为32欧元和117欧元。这一显著差异主要是由于检查时间的节省、更高的年检查频率、更低的材料成本以及无需使用造影剂。在诊断效果方面，MDCT在结石病诊断上比IVU准确得多，在鉴别诊断方面也明显更准确。
与IVU相比，MDCT在急性腰痛患者中可变成本更低，在正确诊断结石病和鉴别诊断方面能力更强。因此，仅从成本效益角度评估时，MDCT是IVU的主要替代方法。
