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CT检查中肝脏偶发病变的管理:美国放射学会偶发发现委员会白皮书

Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee.

作者信息

Gore Richard M, Pickhardt Perry J, Mortele Koenraad J, Fishman Elliot K, Horowitz Jeanne M, Fimmel Claus J, Talamonti Mark S, Berland Lincoln L, Pandharipande Pari V

机构信息

Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois.

Department of Radiology, University of Wisconsin School of Medicine, Madison, Wisconsin.

出版信息

J Am Coll Radiol. 2017 Nov;14(11):1429-1437. doi: 10.1016/j.jacr.2017.07.018. Epub 2017 Sep 18.

Abstract

The ACR Committee on Incidental Findings presents recommendations for managing liver lesions that are incidentally detected on CT. These recommendations represent an update from the liver component of the ACR 2010 white paper on managing incidental findings in the pancreas, adrenal glands, kidneys, and liver. The Liver Subcommittee-which included five abdominal radiologists, one hepatologist, and one hepatobiliary surgeon-developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches categorize liver lesions on the basis of patient characteristics and imaging features. They terminate with an assessment of benignity or a specific follow-up recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected liver lesions.

摘要

美国放射学会(ACR)偶然发现委员会提出了关于管理CT偶然发现的肝脏病变的建议。这些建议是对ACR 2010年关于胰腺、肾上腺、肾脏和肝脏偶然发现管理白皮书肝脏部分内容的更新。肝脏小组委员会——由五名腹部放射科医生、一名肝病学家和一名肝胆外科医生组成——制定了该算法。这些建议借鉴了已发表的证据和专家意见,并通过非正式的迭代共识最终确定。算法分支根据患者特征和影像学特征对肝脏病变进行分类。它们以良性评估或具体的随访建议结束。该算法涵盖了大多数但并非所有的病理情况和临床场景。目标是通过提供关于如何管理偶然发现的肝脏病变的指导来提高医疗质量。

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