The purpose of this study was to compare the cost-effectiveness of sonography and CT for the evaluation of renal masses discovered at excretory urography.
The records of 225 patients with a renal mass shown by urography who then had either sonography or CT within 3 months were reviewed retrospectively.
The number, location, and size of lesions ; initial and subsequent imaging tests ; and final diagnoses were determined.
Using the current Medicare reimbursements for sonography and CT, we calculated the economic implications of using sonography or CT as the initial examination.
Any effect of the location or size of the lesion on the most cost-effective examination was also determined.
Twenty-one percent of patients had both initial sonography and follow-up CT because of indeterminate findings or detection of a solid mass that required further staging.
When CT was done first, CT findings were equivocal in 12%, necessitating follow-up sonography.
At the prevailing charges, CT would have to be needed in 70% of patients initially imaged with sonography to justify the use of CT as the initial examination.
The location and size of the lesion did not affect the need for CT at a rate (greater than 70%) that would economically justify use of CT as the first imaging test.
Eighty-six percent of patients with a mass detected by urography had either a simple cyst or no evidence of a mass on sonography or CT.
Mots-clés Pascal : Appareil urinaire pathologie, Rein pathologie, Tumeur, Rein, Diagnostic, Homme, Exploration ultrason, Echographie, Radiodiagnostic, Tomodensitométrie, Etude économique, Coût, Efficacité, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Urinary system disease, Renal disease, Tumor, Kidney, Diagnosis, Human, Sonography, Echography, Radiodiagnosis, Computerized axial tomography, Economic study, Costs, Efficiency, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0176395
Code Inist : 002B24A05. Création : 09/06/1995.