超声、CT及MRI对腮腺肿瘤定性诊断价值的卫生经济学分析  

Health economics analysis of the qualitative diagnostic value of ultrasound, CT and MRI in parotid gland tumors

作　　者：刘丽东[1] 张卫[1] 王琛[1] 李强[1] 刘宇[1] 赵阳[1] 黄向阳[1] 阳君[1] 赖少侣[1] 苏丹柯[1] LIU Lidong;ZHANG Wei;WANG Chen;LI Qiang;LIU Yu;ZHAO Yang;HUANG Xiangyang;YANG Jun;LAI Shaolii;SU Danke(Center of Imaging Diagnosis,the Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院影像诊断中心,广西南宁530021

出　　处：《实用放射学杂志》2018年第11期1675-1677,1685,共4页Journal of Practical Radiology

摘　　要：目的 分析超声（US）、CT及MRI对腮腺肿瘤定性诊断价值的卫生经济学意义。方法 回顾性分析经病理证实腮腺肿瘤患者128例的术前US、CT和/或MRI影像学表现，计算US、CT、MRI、US＋CT、US＋MRI及CT＋MRI对腮腺肿瘤定性诊断敏感度、特异度、准确度及诊断效能，并对照分析各检查方案的成本-效果比（CER）。结果 US、CT、MRI、US＋CT、US＋MRI及CT＋MRI对腮腺肿瘤定性诊断准确度分别为64.71%、68.75%、92.68%、79.83%、94.44%及85.37%，其中US＋MRI的诊断效能最高，其敏感度、特异度及受试者工作特征曲线（ROC曲线）的曲线下面积分别为80.00%、100.00%及0.90。6种影像学检查方案的CER分别为1.03、17.36、11.95、15.78、12.43、26.95，US诊断的CER最低。结论 US可作为腮腺肿瘤定性诊断的首选影像学检查技术，US联合MRI和/或CT检查可提高腮腺肿瘤诊断的准确度。Objective To analyze health economics significance of the qualitative diagnostic value of ultrasound（US）, CT or MRI in parotid gland tumors.Methods Preoperative data of US,CT or MRI of 128 patients with parotid gland tumors confirmed by pathology were analyzed retrospectively. Sensitivity, specificity,accuracy and diagnostic efficiency of the qualitative diagnosis of US,CT, MRI, US-C-CT, US＋ MRI and CT＋ MRI in parotid gland tumors were calculated, and cost-effectiveness ratio（CER） between examination programs was compared.Results The qualitative diagnostic accuracy of US, CT, MRI, US＋ CT, US＋ MRI and CT＋ MRI in parotid gland tumors were 64.71 %, 68.75 %, 92.68 %, 79.83 %, 94.44 % and 85.37 % respectively. The diagnostic efficiency of US＋ MRI was the best, which sensitivity, specificity and the area under the receiver operating characteristic（ROC） curve were 80.00 %, 100.00% and 0.90 respectively.CER of six examinations were 1.03, 17.36, 11.95, 15.78, 12.43 and 26.95, respectively.CER of US was the lowest.Conclusion US should be the first-choice imaging examination for qualitative diagnosis of parotid gland tumors. US combined MRI and （or） CT can improve the diagnostic accuracy of parotid gland tumors.

关 键 词：腮腺 超声 计算机体层成像 磁共振成像 卫生经济学 

分 类 号：R739.91[医药卫生—肿瘤] R445.1[医药卫生—临床医学]