Henn Curtis M, Weiss Arnold-Peter, Akelman Edward
Department of Orthopaedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI, USA.
J Surg Orthop Adv. 2010 Fall;19(3):159-61.
The objective of this study was to assess prospectively the utility of magnetic resonance imaging (MRI) obtained before evaluation by a hand surgeon. Over a 4-week period, the hand surgeon documented the type of imaging used in each encounter, which prereferral MRIs were useful, and if he agreed with the radiologist's interpretation. Of 396 consecutive patients, 14 (4%) presented with an MRI. Of those MRIs, 10 were found to be useful. The hand surgeons agreed with the radiologist's interpretation on 13 of the 14. Eleven patients presented with only an MRI, and 10 of those were helpful. In contrast, none (0 of 3) of the MRIs of patients who presented with both radiographs and an MRI were useful (p = .01). These results suggest that previous retrospective studies may be confounded by recall bias. The data support the selective ordering of MRIs by referring physicians; however, ordering more than one imaging modality is less likely to be helpful.
本研究的目的是前瞻性地评估在手外科医生进行评估之前获得的磁共振成像（MRI）的效用。在为期4周的时间里，手外科医生记录了每次会诊中使用的成像类型、转诊前哪些MRI是有用的，以及他是否同意放射科医生的解读。在396例连续患者中，14例（4%）进行了MRI检查。在这些MRI检查中，发现10例是有用的。手外科医生在14例中的13例中同意放射科医生的解读。11例患者仅进行了MRI检查，其中10例是有帮助的。相比之下，同时进行了X光片和MRI检查的患者中，没有一例（3例中的0例）MRI是有用的（p = 0.01）。这些结果表明，以往的回顾性研究可能受到回忆偏倚的影响。数据支持转诊医生对MRI进行选择性开具；然而，开具不止一种成像方式不太可能有帮助。
