AIMTo determine whether contrast-enhanced ultrasonography (CEUS) as the first-line method is more cost-effective in evaluating incidentally discovered focal liver lesions (FLLs) than is computed tomography (CT) and magnetic resonance imaging (MRI).METHODSBetween 2010 and 2015, our prospective study enrolled 459 patients with incidentally found FLLs. The biological nature of FLLs was assessed by CEUS in all patients. CT or MRI examinations were added in unclear cases. The sensitivity and specificity of CEUS were calculated. The total costs of CEUS examinations and of the added examinations performed in inconclusive cases were calculated. Afterwards, the theoretical expenses for evaluating incidentally discovered FLLs using CT or MRI as the first-line method were calculated. The results were compared.RESULTSThe total cost of the diagnostic process using CEUS for all enrolled patients with FLLs was 75884 USD. When the expenses for additional CT and MRI examinations performed in inconclusive cases were added, the total cost was 90540 US dollar (USD). If all patients had been examined by CT or MR as the first-line method, the costs would have been 78897 USD or 384235 USD, respectively. The difference between the cost of CT and CEUS was 3013 USD (4%) and that between MRI and CEUS was 308352 USD (406.3%). We correctly described 97.06% of benign or malignant lesions, with 96.99% sensitivity and 97.09% specificity. Positive predictive value was 94.16% and negative predictive value was 98.52%. In cases with 4 and more lesions, malignancy is significantly more frequent and inconclusive findings significantly less frequent (P < 0.001).CONCLUSIONWhile the costs of CEUS and CT in evaluating FLLs are comparable, CEUS examination is far more cost-effective in comparison to MRI.
PŮVODNÍ PRÁCE ORIGINAL PAPERje přítomna, maximálně do 30 minut. MTBI se dělí dále do tří kategorií, na základě GCS a ev. přítomnosti rizikových faktorů. MTBI zahrnuje i prostý úraz hlavy (kategorie 1), který se vyznačuje GCS 15 a ev. přítomností jednoho z minoritních rizikových faktorů (ztráta vědomí, přetrvávající anterográdní amnézie, ložiskový neurologický deficit a hematom v oblasti skalpu) (32). Incidence MTBI je asi 130 případů/100 000 obyvatel, je přitom pravděpodobně podhodnocena, protože řada zraněných nevyhledá lékařskou péči. MTBI tak tvoří až 95 % všech mozkových poranění [1]. Management těchto ÚVOD Kraniocerebrální traumata se podílejí ze 40 % na úrazové mortalitě (1). Incidence mozkových traumat v České republice se pohybuje v rozmezí 180-220 případů na 100 000 obyvatel ročně. Ve věkové skupině do 45 let jsou nejčastější příčinou úmrtí. Každoročně je hospitalizováno téměř 36 tisíc pacientů pro nitrolební poranění, z čehož přibližně 30 tisíc hospitalizací tvoří pacienti s komocí mozku (23). Právě lehká mozková traumata (Mild Traumatic Brain Injury -MTBI) tvoří největší skupinu poranění hlavy. Jsou definována Glasgow Coma Scale (GCS) v rozmezí 13-15 a ztrátou vědomí, pokud
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.