Department of Radiology, Jefferson Medical College and Thomas JeffersonUniversity Hospital, Philadelphia, Pennsylvania 19107, USA.
J Am Coll Radiol. 2010 Nov;7(11):854-8. doi: 10.1016/j.jacr.2010.05.007.
The aim of this study was to analyze trends in the utilization of CT angiography (CTA) and MR angiography (MRA) of the head and neck in the Medicare population over a 6-year interval.
Nationwide Medicare Part B fee-for-service databases were reviewed. Current Procedural Terminology® codes for CTA and MRA of the head and neck were selected. MRA codes included studies without contrast, with contrast, and without and with contrast. Yearly and aggregate procedure volumes were compared for each Current Procedural Terminology code and modality. Data were also analyzed regarding contrast utilization and cost.
From 2002 to 2007, the volume of head CTA increased by 827%, and the overall volume of head MRA increased by 39%. The year-to-year percentage increase in overall volume of head MRA declined throughout the study period; almost all of the increase in the overall volume of head MRA occurred from 2002 to 2005. The volume of neck CTA increased by 1,074%, and the overall volume of neck MRA increased by 31%. An 18% decrease in the volume of neck MRA without contrast was offset by a 104% increase in the volume of neck MRA using contrast. The year-to-year percentage increase in the overall volume of neck MRA declined from 2002 to 2005; there was a decrease in volume of 3% from 2005 to 2007. From 2002 to 2007, when considering all study types, procedure volume increased by 71%; aggregate allowable charges increased by $181 million. Examinations using contrast increased by 235%. In 2002, 23% of examinations used contrast; in 2007, 46% of examinations used contrast.
The rate of growth for head and neck CTA was dramatically higher than for MRA. Neck MRA using contrast also showed substantial growth. The Medicare population is now receiving more contrast material and radiation to noninvasively assess the arterial vasculature of the head and neck.
本研究旨在分析 Medicare 人群中头颈部 CT 血管造影（CTA）和磁共振血管造影（MRA）的使用趋势，时间跨度为 6 年。
回顾了全国 Medicare 部分 B 按服务收费数据库。选择了头颈部 CTA 和 MRA 的当前程序术语（CPT）代码。MRA 代码包括无对比、有对比、无对比和有对比的研究。比较了每个 CPT 代码和模式的每年和总程序量。还分析了对比利用率和成本的数据。
从 2002 年到 2007 年，头 CTA 的数量增加了 827%，头 MRA 的总体数量增加了 39%。整个研究期间，头 MRA 的总数量的年增长率逐年下降；头 MRA 的总数量的增加几乎都发生在 2002 年至 2005 年期间。颈 CTA 的数量增加了 1074%，颈 MRA 的总体数量增加了 31%。颈 MRA 无对比的数量减少了 18%，而颈 MRA 使用对比的数量增加了 104%。颈 MRA 的总数量的年增长率从 2002 年到 2005 年下降；2005 年至 2007 年数量减少了 3%。从 2002 年到 2007 年，考虑到所有研究类型，程序量增加了 71%；总可计费费用增加了 1.81 亿美元。使用对比的检查增加了 235%。2002 年，23%的检查使用了对比剂；2007 年，46%的检查使用了对比剂。
头颈部 CTA 的增长率明显高于 MRA。使用对比剂的颈 MRA 也有显著增长。医疗保险人群现在接受更多的造影剂和辐射，以无创方式评估头颈部的动脉血管。
