Schröder R J, Hidajat N, Vogl T, Haas N, Südkamp N, Schedel H, Felix R
Strahlenklinik, Universitätsklinikum Rudolf Virchow Freie UniversitätBerlin.
Aktuelle Radiol. 1995 Jan;5(1):1-6.
During three months of 1993, 201 primary traumatologic patients (125 m, 76 f, x = 42.6 years) underwent 230 computed tomography examinations (= one CT of one body region) in the radiologic department of the Rudolf Virchow University Hospital. 87.0% of the CT's were performed completely without contrast media, 2.6% exclusively supported by intravenously given contrast media, 9.1% in both ways, and 1.3% after intra-articular contrast media administration. 97.4% served for primary diagnostic purposes and 2.6% for the control of therapeutic results. In 47.8% of the CT's, the principle diagnosis in the scanned body region was known before CT, i.e. by conventional X-ray examinations, but further detailed information was necessary to clarify the indication for operation and to choose the operative mode. In 52.2%, the diagnosis without CT was impossible by other, non-invasive and not more expensive methods. The CT diagnoses were correctly positive in 58.7% (suspected diagnosis verified, additional detail information...) and correctly negative in 41.3% (suspected diagnosis excluded). 60.9% of CT's demonstrated a missing indication for operation in the examined body region; in 39.1% the operation followed. The most frequently performed diagnostic methods before CT were conventional X-ray and sonography, whereas after CT further examinations were seldom needed. We conclude that traumatologic CT's contribute decisively to the reduction of costs by avoiding more expensive examination methods, avoiding redundant operations, and abridging stay duration in the hospital because of more efficient therapy planning.
1993年的三个月期间，201名原发性创伤患者（男性125名，女性76名，平均年龄42.6岁）在鲁道夫·菲尔绍大学医院放射科接受了230次计算机断层扫描检查（即对身体一个部位进行一次CT检查）。87.0%的CT检查完全未使用造影剂，2.6%仅通过静脉注射造影剂辅助进行，9.1%两种方式都采用，1.3%在关节内注射造影剂后进行。97.4%的检查用于初步诊断，2.6%用于治疗效果的评估。在47.8%的CT检查中，扫描身体部位的主要诊断在CT检查前就已通过传统X线检查得知，但仍需要进一步详细信息以明确手术指征并选择手术方式。在52.2%的情况下，通过其他非侵入性且成本较低的方法无法做出无CT检查时的诊断。CT诊断正确阳性率为58.7%（可疑诊断得到证实，获取了额外详细信息……），正确阴性率为41.3%（可疑诊断被排除）。60.9%的CT检查显示所检查身体部位不存在手术指征；39.1%的情况随后进行了手术。CT检查前最常用的诊断方法是传统X线检查和超声检查，而CT检查后很少需要进一步检查。我们得出结论，创伤性CT检查通过避免更昂贵的检查方法、避免不必要的手术以及因更有效的治疗计划缩短住院时间，对降低成本起到了决定性作用。
