İnsidental Adrenal Kitlelerin Değerlendirilmesinde Manyetik Rezonans ve Bilgisayarlı Tomografinin Direkt ve Dolaylı Maliyetlerinin Karşılaştırılması

Abstract

Objective: It was planned to compare the direct and indirect costs of computed tomography (CT) and magnetic resonance (MR) methods in the differentiation of adrenal adenoma and non adenoma. Material and Methods: CT, MR, pathology, laboratory and other information of the patients were obtained from the patient files. Radiological examination and unilateral laparoscopic adrenalectomy cost information was obtained from the accounting department. For cost calculation; the scenario was used in which 500 patients were referred equally to CT and MR, individuals diagnosed with non-adenoma were referred to the operation after the first control, individuals diagnosed with adenoma were followed, and standard follow-up was done every 6 months for 4 years. Results: A total of 31 patients (8 males and 23 females) were eligible for the study. The mean age of the patients was 48.1+17.7 years. In the CT group, an excess cost of 609,0 ₺ per person for 1 year and 2435,9 ₺ per person for 4 years was incurred. In the diagnosis of adenoma and non-adenoma, CT was inaccurate in 24.4% of patients, whereas MR was inaccurate in 5.2%. When used for the diagnosis of pheochromocytoma, it was found that in the CT group, 609,0 ₺ per person for 1 year and 2435,9 ₺ per person for 4 years resulted in an excess cost, whereas CT was erroneous in 17.6% of patients and MR in 15.8% of patients. In the diagnosis of malignancy, in the CT group, an excess cost of 522,2 ₺ per person for 1 year and 2088,7 ₺ per person for 4 years was incurred. It was determined that correct decision could not be made in 33.2% of the patients in the CT group and in 5.8% of the patients in the MR group. Conclusion: The use of contrast-enhanced MR in patients of adrenal masses reduces unnecessary interventions and the resulting expenditures.