Robson A K, Leighton S E, Anslow P, Milford C A
Department of Otolaryngology, Radcliffe Infirmary, Oxford, UK.
J R Soc Med. 1993 Aug;86(8):455-7.
Magnetic resonance imaging (MRI) is accepted as the 'gold standard' in diagnosing acoustic neuromas. Limited availability and perceived high costs have prevented clinicians from using it as a first-line investigation. A prospective study was set up in a specially designated screening session to audit the cost effectiveness and accuracy of audiovestibular investigations compared to MRI. Ninety-nine patients with asymmetrical audiovestibular symptoms or signs were investigated. Of these 54 evoked response audiometry tests, and 39 calorics were either not performed or were inconclusive. One patient refused to enter the MRI machine. All others received an unequivocal report after MRI and four tumours (three intracanalicular) were detected. The total cost of the audiovestibular protocol was 12,545 pounds compared to 12,900 pounds for the MRI protocol, which is a diagnostic and well-tolerated procedure. This study shows that MRI can be cost effective, as well as accurate, when used as a single screening procedure for acoustic neuromas.
磁共振成像（MRI）被公认为诊断听神经瘤的“金标准”。可用性有限和高昂的费用使临床医生无法将其作为一线检查手段。在一次专门指定的筛查环节中开展了一项前瞻性研究，以评估与MRI相比，听-前庭检查的成本效益和准确性。对99例有不对称听-前庭症状或体征的患者进行了检查。其中54例未进行或诱发反应测听检查结果不确定，39例冷热试验检查结果也不确定。1例患者拒绝进入MRI检查室。其他所有患者在接受MRI检查后都得到了明确的报告，共检测出4例肿瘤（3例为管内型）。听-前庭检查方案的总费用为12,545英镑，而MRI检查方案的费用为12,900英镑，MRI是一种诊断性良好且耐受性好的检查方法。这项研究表明，当MRI用作听神经瘤的单一筛查程序时，它具有成本效益且准确。
