钼靶和超声及MRI对乳腺癌的诊断价值多中心研究及卫生经济学评价

The multi-center research on diagnostic value and health economic evaluation of MRI,ultrasonography,and X-ray mammography in breast cancer

目的:探讨单一或联合不同影像学检查技术(乳腺钼靶、超声、MRI)对乳腺癌诊断的临床应用价值及卫生经济学意义。方法:本研究采用回顾性调查方法,搜集了乳腺疾病患者559例,所有患者术前均行钼靶、超声及MRI检查。计算钼靶、超声、MRI、钼靶和超声、钼靶和MRI及超声和MRI 6种影像学检查方案对乳腺癌的诊断效能,并分析比较其卫生经济学指标(成本-效果比)。结果:钼靶、超声、MRI、钼靶和超声、钼靶和MRI及超声和MRI 6种影像学检查方案对乳腺癌的诊断准确率分别为76.62%、81.91%、94.03%、88.23%、92.66%及92.66%。6种影像学检查方案的成本-效果比分别为2.61、0.95、13.69、3.15、16.05、14.73。结论:超声诊断相对于其他5种影像学检查方案成本-效果比最低,是诊断乳腺癌经济有效的方法。但MRI检查诊断效能最佳,在经济条件允许的情况下,采用MRI检查可以得到更好的诊断效果。

Objective：To investigate the clinical diagnostic value and health economic significance of single or combined different imaging examination techniques（mammography,ultrasonography,MRI）in the diagnosis of breast cancer.Methods：The retrospective study collected 559 patients with586 breast lesions.All patients underwent mammography,ultrasonography and MRI examination before operation.6 kinds of imaging examination scheme for the diagnosis of breast cancer including mammography,ultrasonography,magnetic resonance imaging（MRI）, ＂ mammography and ultrasonography＂, ＂ mammography and MRI＂ and ＂ ultrasonography and MRI＂ were implemented,and the health economics indexes（cost-effectiveness ratio）were compared.Results：The diagnostic accuracy of the six plans were 76.62%,81.91%,94.03%,88.23%,92.66% and 92.66%respectively.The cost-effectiveness ratio of the six kinds were 2.61,0.95,13.69,3.15,16.05,14.73 respectively.Conclusion：Compared with the other five imaging examinations,ultrasonic diagnosis has the lowest cost-effectiveness ratio and is an effective method for the diagnosis of breast cancer.In the case of permitted economic conditions,MRI examination can be used to obtain better diagnostic results.