Bosma Jan, Dijksman Lea M, Lam Kayan, Wisselink Willem, van Swijndregt Alexander D Montauban, Vahl Anco
Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
Acta Radiol. 2014 Apr;55(3):279-86. doi: 10.1177/0284185113496560. Epub 2013 Aug 12.
Contrast-enhanced magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (DSA) both have a high diagnostic performance in the imaging of peripheral arterial occlusive disease (PAOD). However, little is known about the effects of initial, preoperative imaging using MRA or DSA on quality of life (QoL) in relation to costs (cost-utility).
To compare cost-utility of treatment strategies using either MRA or DSA as the principal imaging tool, related to QoL, in patients with PAOD.
In a prospective subgroup analysis of patients randomized between MRA and DSA (n = 79) for preoperative imaging, QoL questionnaires (SF-36) were obtained at randomization and at 4-month follow-up. Cost-effectiveness from hospital perspective was subsequently compared between groups and the difference in gained or lost QoL per € spent assessed using bootstrap analysis.
No difference in quality of life was found. A treatment trajectory employing MRA as the principal imaging modality was almost 20% cheaper, leading to a better cost-utility ratio in favor of MRA.
A treatment plan for peripheral arterial occlusive disease employing MRA versus DSA as the principal imaging modality yields a better cost/QoL ratio for MRA.
对比增强磁共振血管造影（MRA）和动脉内数字减影血管造影（DSA）在外周动脉闭塞性疾病（PAOD）成像中均具有较高的诊断性能。然而，关于使用MRA或DSA进行初始术前成像对生活质量（QoL）与成本（成本效用）的影响知之甚少。
比较以MRA或DSA作为主要成像工具的治疗策略在PAOD患者中的成本效用，并与QoL相关。
在一项对随机分配接受MRA和DSA（n = 79）术前成像的患者进行的前瞻性亚组分析中，在随机分组时和4个月随访时获取QoL问卷（SF - 36）。随后比较两组从医院角度的成本效益，并使用自举分析评估每花费1欧元获得或损失的QoL差异。
未发现生活质量有差异。以MRA作为主要成像方式的治疗方案便宜近20%，从而使MRA的成本效用比更优。
以外周动脉闭塞性疾病的治疗方案中，以MRA而非DSA作为主要成像方式，MRA的成本/ QoL比更佳。
