Arora Silvia, Popkin Charles A, Wong Tony T
Department of Radiology, Division of Musculoskeletal Radiology, New York-Presbyterian Hospital Columbia University Medical Center, 622 West 168th Street, MC-28, New York, NY 10032.
Department of Orthopedic Surgery, The Center for Shoulder, Elbow, and Sports Medicine, New York-Presbyterian Hospital Columbia University Medical Center, 622 West 168th Street, PH-11, New York, NY 10032.
Curr Probl Diagn Radiol. 2023 Sep-Oct;52(5):346-352. doi: 10.1067/j.cpradiol.2023.02.002. Epub 2023 Feb 8.
The purpose is to evaluate the trends in MR arthrogram utilization at a tertiary care academic institution and to determine if there are factors that can be implicated in the utilization trends. Number of MR arthrograms of the shoulder, hip, and elbow from 2013-2020 at our institution were identified (n = 1882). Patient demographics including age, sex, sports participation, history of prior surgery, and physician referral were obtained. Descriptive statistics were performed to determine the prevalence of MR arthrograms. Linear regression analyses were performed to determine the relationship of time with prevalence of arthrograms. Chi-square tests and posthoc analyses with Bonferroni correction were used to assess if categorical variables were different between the years. There was overall decrease in the prevalence of MR arthrograms of the shoulder, hip, and elbow despite an increase in the overall MR volume during the study period. Linear regression models significantly predicated decrease in arthrogram prevalence with each passing year (P < 0.001). The percentage of orthopedic referrals for arthrograms in the hip (P = 0.002) and shoulder (P = < 0.001) decreased significantly towards the end of the study period. None of the other variables assessed were significant. At our tertiary care academic institution, arthrogram utilization has been drastically decreasing over the past 8 years. The percentage of orthopedic referrals for shoulder and hip arthrograms significantly decreased at the end of the study period.
目的是评估一家三级医疗学术机构中肩关节造影磁共振成像(MR arthrogram)的使用趋势,并确定是否存在与使用趋势相关的因素。我们确定了本机构2013年至2020年期间肩部、髋部和肘部的MR arthrogram数量(n = 1882)。获取了患者的人口统计学信息,包括年龄、性别、体育活动参与情况、既往手术史和医生转诊情况。进行描述性统计以确定MR arthrogram的患病率。进行线性回归分析以确定时间与arthrogram患病率之间的关系。使用卡方检验和经Bonferroni校正的事后分析来评估各年份之间分类变量是否存在差异。尽管在研究期间总体MR检查量有所增加,但肩部、髋部和肘部的MR arthrogram患病率总体呈下降趋势。线性回归模型显著预测随着时间推移arthrogram患病率会下降(P < 0.001)。在研究期结束时,髋部(P = 0.002)和肩部(P < 0.001)arthrogram的骨科转诊百分比显著下降。评估的其他变量均无显著差异。在我们的三级医疗学术机构,过去8年中arthrogram的使用一直在急剧下降。在研究期结束时,肩部和髋部arthrogram的骨科转诊百分比显著下降。