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首页> 外文期刊>Radiology >Spiral CT angiography for suspected pulmonary embolism: a cost-effectiveness analysis.
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Spiral CT angiography for suspected pulmonary embolism: a cost-effectiveness analysis.

机译：螺旋CT血管造影检查可疑的肺栓塞：成本效益分析。

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PURPOSE: To investigate the cost-effectiveness of diagnostic strategies involving spiral computed tomographic (CT) or conventional pulmonary angiography in the diagnosis of suspected pulmonary embolism. MATERIALS AND METHODS: A model was created for analyzing cost-effectiveness on the basis of available literature data. Diagnostic algorithms consisting of combinations of perfusion and ventilation scintigraphy, ultrasound, D-dimer assay, conventional angiography, and spiral CT angiography were compared. Preference for strategies was determined on the basis of the mortality and cost per life saved. RESULTS: For all realistic values of the pretest probability of pulmonary embolism and coexisting deep vein thrombosis and of the specificity of spiral CT angiography, all of the best strategies included spiral CT angiography. With an assumed sensitivity for spiral CT angiography of less than 85%, a conventional angiographic strategy yielded a lower mortality but did not yield superior cost-effectiveness. CONCLUSION: The use of spiral CT angiography is likely to reduce the mortality and improve cost-effectiveness in the diagnostic work-up of suspected pulmonary embolism.
机译：目的：调查涉及螺旋CT（CT）或常规肺动脉造影的诊断策略在诊断可疑肺栓塞中的成本效益。材料与方法：建立了一个模型，用于根据现有文献数据分析成本效益。比较了由灌注和通气闪烁显像，超声，D-二聚体测定，常规血管造影和螺旋CT血管造影组成的诊断算法。根据死亡率和挽救生命的成本确定对策略的偏好。结果：对于肺栓塞和并存的深静脉血栓形成的前测概率的所有现实价值以及螺旋CT血管造影的特异性，所有最佳策略均包括螺旋CT血管造影。假设螺旋CT血管造影的敏感性低于85％，传统的血管造影策略可降低死亡率，但并不能提供出色的成本效益。结论：螺旋CT血管造影的使用可能会降低可疑肺栓塞的诊断性检查的死亡率并提高成本效益。

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