MR imaging of the wrist: Effect on clinical diagnosis and patient care
MR imaging of the wrist: Effect on clinical diagnosis and patient care
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DOI：
10.1148/radiol.2203001429
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发表时间：
2001-09-01
期刊：
影响因子：
19.7
通讯作者：
Matthewson, MH
中科院分区：
文献类型：
--
作者：
Hobby, JL;Dixon, AK;Matthewson, MH
目的：评价腕部磁共振成像在临床医生诊断、诊断确定性和病人护理中的作用。材料和方法：进行对照观察性研究。咨询的临床医生在腕部磁共振成像前后完成了关于诊断和意向处理的问卷。118名连续接受腕部磁共振成像的患者来自一家地区性教学医院和一家大型地区性综合医院的磁共振成像单元。结果：5例患者问卷填写错误，3例患者问卷未发回，10例患者取消预约，2例患者不能耐受MR检查。有98名患者获得了完整的随访数据。在98名患者中，有55名患者的临床诊断发生了改变；在其余43名患者中，有23名患者的诊断确定性增加。临床医生报告说，在98名患者中，有67名患者的磁共振成像显著提高了他们对疾病的了解。98名患者中有45名改变了护理计划，放弃了手术治疗。28名患者在没有进一步调查的情况下出院。磁共振成像在地区教学中心和地区综合医院同样有效。结论：腕部磁共振成像影响临床医生的诊断和管理计划。
PURPOSE: To evaluate the effect of magnetic resonance (MR) imaging of the wrist on clinicians' diagnoses, diagnostic certainty, and patient care.MATERIALS AND METHODS: A controlled observational study was performed. Referring clinicians completed questionnaires about diagnosis and intended management before and after wrist MR imaging. One hundred eighteen consecutive patients referred for MR imaging of the wrist were recruited from the MR imaging units at a regional teaching hospital and a large district general hospital. The main measures were changes in the clinicians' leading and subsidiary diagnoses after MR imaging, their certainty in these diagnoses, and changes in intended patient care.RESULTS: Questionnaires were incorrectly completed for five patients, questionnaires were not returned for three, appointments were canceled for 10, and two could not tolerate the MR examination. Complete follow-up data were available for 98 patients. The clinical diagnosis changed in 55 of 98 patients; in the remaining 43 patients, diagnostic certainty increased in 23. Clinicians reported that MR imaging had substantially improved their understanding of the disease in 67 of 98 patients. The care plan changed in 45 of 98 patients, with a shift away from surgical treatment. Twenty-eight patients were discharged without further investigation. MR imaging was similarly effective in the regional teaching center and the district general hospital.CONCLUSION: MR imaging of the wrist influences clinicians' diagnoses and management plans.