Siddiqui Taha A, Chamarti Kiran S, Tou Leila C, Demirjian Gregory A, Noorani Sarah, Zink Sydney, Umair Muhammad
Philadelphia College of Osteopathic Medicine, 625 Old Peachtree Rd. NW, Suwanee, GA 30024, USA.
Charles E. Schmidt College of Medicine at Florida Atlantic University, 777 Glades Road BC-71, Boca Raton, FL 33431, USA.
J Cardiovasc Dev Dis. 2022 Oct 17;9(10):357. doi: 10.3390/jcdd9100357.
Cardiac magnetic resonance (CMR) imaging has a wide range of clinical applications with a high degree of accuracy for many myocardial pathologies. Recent literature has shown great utility of CMR in diagnosing many diseases, often changing the course of treatment. Despite this, it is often underutilized possibly due to perceived costs, limiting patient factors and comfort, and longer examination periods compared to other imaging modalities. In this regard, we conducted a literature review using keywords "Cost-Effectiveness" and "Cardiac MRI" and selected articles from the PubMed MEDLINE database that met our inclusion and exclusion criteria to examine the cost-effectiveness of CMR. Our search result yielded 17 articles included in our review. We found that CMR can be cost-effective in quality-adjusted life years (QALYs) in select patient populations with various cardiac pathologies. Specifically, the use of CMR in coronary artery disease (CAD) patients with a pretest probability below a certain threshold may be more cost-effective compared to patients with a higher pretest probability, although its use can be limited based on geographic location, professional society guidelines, and differing reimbursement patterns. In addition, a stepwise combination of different imaging modalities, with conjunction of AHA/ACC guidelines can further enhance the cost-effectiveness of CMR.
心脏磁共振成像（CMR）在临床上有广泛应用，对多种心肌病变具有高度准确性。近期文献表明，CMR在诊断多种疾病方面具有很大作用，常常改变治疗进程。尽管如此，由于感知到的成本、限制患者的因素和舒适度，以及与其他成像方式相比检查时间更长，CMR的使用常常未得到充分利用。在这方面，我们使用关键词“成本效益”和“心脏磁共振成像”进行了文献综述，并从PubMed MEDLINE数据库中选择了符合我们纳入和排除标准的文章，以研究CMR的成本效益。我们的搜索结果产生了17篇纳入综述的文章。我们发现，在患有各种心脏病变的特定患者群体中，CMR在质量调整生命年（QALY）方面具有成本效益。具体而言，与预检概率较高的患者相比，在预检概率低于一定阈值的冠状动脉疾病（CAD）患者中使用CMR可能更具成本效益，尽管其使用可能会因地理位置、专业学会指南和不同的报销模式而受到限制。此外，不同成像方式的逐步组合，结合美国心脏协会（AHA）/美国心脏病学会（ACC）指南，可以进一步提高CMR的成本效益。
