Baldor R A, Quirk M E, Dohan D
Department of Family and Community Medicine, University of Massachusetts Medical Center, Worcester 01655.
J Fam Pract. 1993 Mar;36(3):281-5.
Magnetic resonance imaging (MRI) has recently been introduced in the United States as an imaging technique for clinical use. Initially used by neurologists to view the brain stem, its indications have rapidly expanded to include spine, pelvis, bone marrow, and joints. This has raised concerns over the appropriate, cost-effective use of such an expensive technology. This paper examines MRI scanning patterns that have developed over time in central Massachusetts and surveys primary care knowledge, attitudes, and patterns of utilization.
The two MRI centers in central Massachusetts were surveyed for information about the number and types of scans ordered and the specialties of the physicians who ordered the scans. Questionnaires were sent to primary care physicians in Worcester County to assess knowledge and attitudes about MRI and utilization.
The data demonstrate changing patterns of MRI utilization over time. Orthopedics has been the specialty with the greatest increase in use, now slightly surpassing neurology in the total number of scans ordered. Primary care physician use has doubled over this same period. Not all primary care physicians utilize MRI, but those who have used the technology have familiarized themselves with its indications and problems and have a better knowledge about its costs.
Utilization patterns of MRI have changed considerably in a short time, with primary care physicians requesting use of this new technology much more frequently than when it was first introduced.
磁共振成像（MRI）最近在美国作为一种临床应用的成像技术被引入。最初由神经科医生用于观察脑干，其应用范围迅速扩大到包括脊柱、骨盆、骨髓和关节。这引发了人们对如此昂贵技术的合理、成本效益使用的担忧。本文研究了马萨诸塞州中部随时间发展形成的MRI扫描模式，并调查了初级保健医生的知识、态度和使用模式。
对马萨诸塞州中部的两个MRI中心进行了调查，以获取有关所订购扫描的数量和类型以及订购扫描的医生专业的信息。向伍斯特县的初级保健医生发送了问卷，以评估他们对MRI的知识、态度和使用情况。
数据表明MRI的使用模式随时间而变化。骨科是使用量增长最大的专业，目前在订购的扫描总数上略超过神经科。同期初级保健医生的使用量增加了一倍。并非所有初级保健医生都使用MRI，但那些使用过该技术的医生已经熟悉了其适应症和问题，并对其成本有了更好的了解。
MRI的使用模式在短时间内发生了很大变化，初级保健医生比该技术首次引入时更频繁地要求使用这项新技术。
