Cummings JP, Matuszewski KA; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1996; 12: 15.
University HealthSystem Consortium, Clinical Practice Advancement Center, Oak Brook, IL, USA.
Magnetic resonance angiography (MRA) is a non-invasive diagnostic technique used to image blood vessels. MRA can be performed on a conventional MR scanner equipped with flow-visualization software packages. MRA techniques may be generally classifed as two-dimensional or three-dimensional, time-of-flight or phase-contrast. An important distinction in evaluating MRA is one of efficacy versus effectiveness. Clinical efficacy describes use in a carefully controlled, experimental setting. Clinical effectiveness describes the routine use in the general population in a variety of settings. Though MRA has proven efficacy in almost all blood vessels, its effectiveness is limited to selected vessel segments in the head, neck, lower extremities, and abdomen. A controversy involving MRA surrounds its use in perioperative imaging strategies. Appropriate and cost-effective uses of MRA have been identified through survey of members of the University HealthSystem Consortium (UHC). MRA is most widely accepted as a screening tool. MRA has been used as the sole pre-operative imaging modality following validation of the sequence against conventional x-ray angiography (CA). MRA is often used in a tiered protocol in conjunction with duplex ultrasound and CA. For example, ultrasound is used as the initial screening study. Patients with stenosis above a cut-off point are referred to MRA. In cases of agreement between MRA and ultrasound, CA is not required. CA is reserved for only the most difficult cases. A cost-based model of this protocol demonstrates savings when a sufficient percentage of patients can be spared the combination of all three tests. For duplication of diagnostic tests, the diagnostic increment is small, whereas the incremental cost is large.
Publication Types:
Keywords:
- Angiography
- Blood Vessels
- Humans
- Magnetic Resonance Angiography
- diagnosis
- radiography
- hsrmtgs
Other ID:
UI: 102222502
From Meeting Abstracts