Geitung J T, Wikström T, Zeuchner J, Göthlin J H
Department of Radiology, East Hospital, Gothenburg, Sweden.
Eur Radiol. 1996;6(4):481-4. doi: 10.1007/BF00182475.
The present investigation was performed to assess the clinical consequences, utility and efficacy of colour duplex sonography (CDS) compared with angiography as a preoperative examination in aorta, pelvis and lower limb, and thus to estimate the cost-effectiveness of CDS. CDS was additionally performed in 53 consecutive patients referred for preoperative angiography of the lower limb. The results for 49 patients were reviewed and compared to assess the technique's clinical utility. The costs of the two methods and the consequences of inappropriate treatment were assessed. In 15 patients inadequate diagnoses were obtained at CDS. If surgery had been performed solely on the basis of the ultrasonographic diagnosis, repeat surgery would have been necessary in 9 patients. In a further 3 patients necessary surgery would not have been performed. Two patients would have been overtreated (unnecessary surgery instead of percutaneous transluminal balloon angioplasty). To correct the initial incorrect diagnosis the estimated yearly cost would be approximately 1.3 million Swedish crowns. In addition, complications and discomfort could be anticipated for the patients. Because of its low sensitivity CDS ist not cost-effective as a preoperative investigation of arteries of the pelvis and lower limb.
本研究旨在评估彩色双功超声检查（CDS）与血管造影术相比，作为主动脉、骨盆和下肢术前检查的临床后果、实用性和有效性，从而评估CDS的成本效益。另外，对53例因下肢术前血管造影而转诊的连续患者进行了CDS检查。对49例患者的结果进行了回顾和比较，以评估该技术的临床实用性。评估了两种方法的成本以及不适当治疗的后果。15例患者通过CDS获得了不充分的诊断。如果仅根据超声诊断进行手术，9例患者将需要再次手术。另外3例患者将不会进行必要的手术。2例患者将接受过度治疗（不必要的手术而非经皮腔内球囊血管成形术）。为纠正最初的错误诊断，估计每年的费用约为130万瑞典克朗。此外，还可预期患者会出现并发症和不适。由于其低敏感性，CDS作为骨盆和下肢动脉的术前检查不具有成本效益。
