钆塞酸二钠增强磁共振成像与超声在肝细胞癌筛查中的成本效益分析

陈琪萍; 林苏; 史震山; 朱月永; 李友炳

doi:10.3969/j.issn.1001-5256.2018.09.018

钆塞酸二钠增强磁共振成像与超声在肝细胞癌筛查中的成本效益分析

DOI: 10.3969/j.issn.1001-5256.2018.09.018

1. 福建医科大学附属第一医院肝病中心
2. 福建医科大学附属第一医院影像科

基金项目:

福建省自然科学基金项目(2016Y0039,2015Y0057)；

详细信息

中图分类号: R735.7;R445
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出版历程
- 收稿日期: 2018-03-05
- 出版日期: 2018-09-20

A cost-effectiveness analysis of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging versus ultrasound in hepatocellular carcinoma screening

Liver Research Center, The First Affiliated Hospital of Fujian Medical University

Research funding:

摘要

摘要: 目的比较在肝癌高危人群中采用钆塞酸二钠增强MRI(EMRI)与超声行肝癌筛查的成本效益比。方法应用Tree Age Pro 2011软件建立决策树模型,采用数学模型模拟肝硬化患者每6个月行EMRI或超声筛查的成本与收益,计算不同筛查模式下的成本效益比。结果 EMRI组和超声组平均每人每次用于肝癌筛查的成本分别为2050.2元和262.6元,获得效益分别为0.11生命年(YLG)和0.02 YLG。当肝癌发病率为17.8%时,EMRI组与超声组的成本效益比大致相同,每1个YLG的成本大致均为11445元,肝癌发病率越高,EMRI检查成本越低,筛查效果越好。EMRI价格越低,其成本效益比逐渐下降,筛查效果越明显。结论肝癌筛查的成本效益与肝癌发病率及检查价格密切相关。当肝癌风险高于17.8%时,采用EMRI筛查可获得较好的成本效益比。
- 癌,肝细胞 /
- 磁共振成像 /
- 超声检查 /
- 早期诊断 /
- 费用效益分析
Abstract: Objective To investigate the cost-effectiveness ratio of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging (EMRI) versus ultrasound in liver cancer screening for the high-risk population. Methods The Tree Age Pro 2011 software was used to establish a decision-tree model. A mathematical model was used to simulate the costs and benefits of EMRI or ultrasound screening every 6 months in patients with liver cirrhosis, and the cost-effectiveness ratios under different screening models were calculated. Results The EMRI group had a mean cost of liver cancer screening of 2050. 2 RMB each person each time and mean benefits of 0. 11 YLG, while the ultrasound group had a mean cost of 262. 6 RMB and mean benefits of 0. 02 YLG. When the incidence rate of liver cancer was 17. 8%, the EMRI group had a similar cost-effectiveness ratio as the ultrasound group, and the cost of 1 YLG was 11445 RMB; EMRI tended to have a lower cost and a better effect in screening with the increase in the incidence rate of liver cancer. The cost-effectiveness ratio of EMRI gradually decreased with the reduction in its price, and its effect in screening gradually increased with the reduction in price. Conclusion The cost-effectiveness of liver cancer screening is closely related to the incidence rate of liver cancer and the price of screening. EMRI has a good cost-effectiveness ratio in screening when the risk of liver cancer is higher than 17. 8%.
- carcinoma, hepatocellular /
- magnetic resonance imaging /
- ultrasonography /
- early diagnosis /
- cost-benefit analysis

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