Einsatz der Niederfeld-Extremitäten-Magnet-Resonanz-Tomographie (E-MRT) in der Frakturdiagnostik : Untersuchungen zu Durchführbarkeit, Kosten und Stellenwert
Study objectives: A dedicated low-field MRI was investigated regarding the costs and the diagnostic value in detecting acute fractures of the distal extremities compared to conventional x-ray. Material and methods: 236 patients with the clinical suspicion of a fracture at the distal extremities were primarily examined by 0,2T low-field-MRI (Artoscan?, Esaote, Italy). After that a conventional radiography and a clinical follow up was done. Secondly X-ray and MRI examinations of 78 patients with „save diagnosis“ were separated (41 positive diagnosis, 37 without fracture). Both methods were independently analyzed by two experienced radiologists in regard of the existence of a fracture. In addition the type of fracture was analyzed. The interobserver-variability was calculated for both methods. Results: The costs for a low-field MRI examination were calculated to 100-120$ instead of 10-15$ for a conventional x-ray examination. For the detection of acute fractures of the distal extremities low-field MRI yielded an accuracy of 81.4%, versus 79.5% for x-ray-examination. MRI was less accurate in the detection of small anatomic structures such as fingers or digits. Intraosseous lesions can not be adequately imaged by x-ray examination. Concerning the interobserver-variability both methods had to be rated as ”moderate”. Conclusions: For detecting acute fractures of the distal extremities the accuracy of low-field MRI and conventional x-ray examinations are almost equivalent. The primary non-selective use of a low-field MRI for detecting acute fractures instead of conventional x-ray seems not to be reasonable.
info:eu-repo/classification/ddc/610, Medizin
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