Maurer M H, Froeling V, Röttgen R, Bretschneider T, Hartwig T, Disch A C, de Bucourt M, Hamm B, Streitparth F
Department of Diagnostic and Interventional Radiology, Charité University Medicine Berlin.
Department of Radiology and Nuclear Medicine, Otto von Guericke University Magdeburg.
Rofo. 2014 Jun;186(6):559-66. doi: 10.1055/s-0033-1356169. Epub 2013 Dec 17.
To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain.
Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated.
The mean intervention time was 24.9 min. (range: 12 - 36 min.) for MRI-guided infiltration and 19.7 min. (range: 5 - 54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76.
Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance.
评估并比较磁共振成像（MRI）引导和计算机断层扫描（CT）引导下的颈神经根浸润术治疗神经根型颈部疼痛的成本。
2009年9月至2012年4月期间，22例患者（9例男性，13例女性；平均年龄：48.2岁）接受了MRI引导（1.0特斯拉，全景HFO，飞利浦）的单部位颈神经根周围注射40毫克曲安奈德。另有64例患者（34例男性，30例女性；平均年龄：50.3岁）在CT透视引导下（Somatom Definition 64，西门子）接受治疗。平均总成本计算为设备使用（购买、折旧、维护和能源成本）、人员成本以及MRI和CT引导程序中一次性用品支出的分摊成本之和。此外，还计算了超声引导的成本。
MRI引导下浸润的平均干预时间为24.9分钟（范围：12 - 36分钟），CT引导下浸润的平均干预时间为19.7分钟（范围：5 - 54分钟）。MRI引导干预的每位患者平均总成本为240欧元，CT引导干预的每位患者平均总成本为124欧元。其中（MRI/CT引导）设备使用成本分别为150/60欧元，人员成本分别为46/40欧元，一次性用品成本分别为44/25欧元。超声引导的平均总成本为76欧元。
MRI引导下的颈神经根浸润术成本仍约为CT引导下浸润术的两倍。然而，由于该方法不会使患者和工作人员受到辐射暴露，MRI引导的神经根浸润术可能成为CT引导程序的一个有前景的替代方法，特别是因为预计MRI设备和与MRI兼容的一次性用品价格会进一步下降。相比之下，超声仍然是神经根浸润引导成本较低的方法。
