Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
J Magn Reson Imaging. 2012 Mar;35(3):512-7. doi: 10.1002/jmri.23530. Epub 2011 Dec 16.
In this review we describe the problem of overutilization of high-cost imaging modalities, especially magnetic resonance imaging (MRI) and computed tomography (CT). The overuse of CT is numerically more dramatic and also carries with it the not insignificant risk of harm to patients, namely, induction of radiation-induced malignancies. We report what is known of these risks in various imaging scenarios. The use of Radiology Business Managers is described as a means adopted to control overuse and the limitations of this strategy. The imperative of appropriate utilization is focused on, with emphasis placed on computer-based medical decision support. Impediments to appropriate use, however, exist, with concerns of medicolegal liability high on the list of these issues. Finally, we recommend that radiologists take the lead in the reform process by implementing strategies such as decision support.
在这篇综述中，我们描述了过度使用高成本成像方式（尤其是磁共振成像[MRI]和计算机断层扫描[CT]）的问题。CT 的过度使用在数字上更为显著，而且还会给患者带来不小的危害风险，即诱导辐射致癌。我们报告了在各种成像场景中这些风险的已知情况。本文介绍了使用放射科业务经理作为控制过度使用的手段，以及该策略的局限性。重点关注适当利用的必要性，并强调基于计算机的医疗决策支持。然而，存在适当使用的障碍，其中医疗法律责任的担忧是这些问题中的首要问题。最后，我们建议放射科医生通过实施决策支持等策略来引领改革进程。
