Pannu Harpreet K, Javitt Marcia C, Glanc Phyllis, Bhosale Priyadarshani R, Harisinghani Mukesh G, Khati Nadia J, Mitchell Donald G, Nyberg David A, Pandharipande Pari V, Shipp Thomas D, Siegel Cary Lynn, Simpson Lynn, Wall Darci J, Wong-You-Cheong Jade J
Memorial Sloan Kettering Cancer Center, New York, New York.
Rambam Healthcare Campus, Haifa, Israel.
J Am Coll Radiol. 2015 Feb;12(2):134-42. doi: 10.1016/j.jacr.2014.10.021. Epub 2014 Oct 31.
Pelvic floor dysfunction is a common and potentially complex condition. Imaging can complement physical examination by revealing clinically occult abnormalities and clarifying the nature of the pelvic floor defects present. Imaging can add value in preoperative management for patients with a complex clinical presentation, and in postoperative management of patients suspected to have recurrent pelvic floor dysfunction or a surgical complication. Imaging findings are only clinically relevant if the patient is symptomatic. Several imaging modalities have a potential role in evaluating patients; the choice of modality depends on the patient's symptoms, the clinical information desired, and the usefulness of the test. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions; they are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals, and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
盆底功能障碍是一种常见且可能较为复杂的病症。影像学检查可通过揭示临床上隐匿的异常情况并明确现存盆底缺陷的性质来辅助体格检查。对于临床表现复杂的患者,影像学检查在术前管理中具有重要价值;对于怀疑有复发性盆底功能障碍或手术并发症的患者,影像学检查在术后管理中也能发挥作用。只有当患者出现症状时,影像学检查结果才具有临床相关性。几种影像学检查方法在评估患者方面都有潜在作用;检查方法的选择取决于患者的症状、所需的临床信息以及检查的实用性。美国放射学会(ACR)适宜性标准是针对特定临床情况的循证指南;由多学科专家小组每3年进行一次审查。指南的制定和审查包括对同行评审期刊上的当前医学文献进行广泛分析,并应用成熟的共识方法(改良德尔菲法)由专家小组对影像学检查和治疗程序的适宜性进行评分。在缺乏证据或证据不明确的情况下,可采用专家意见来推荐影像学检查或治疗方法。