Collard Michael, Sutphin Patrick D, Kalva Sanjeeva P, Majdalany Bill S, Collins Jeremy D, Eldrup-Jorgensen Jens, Francois Christopher J, Ganguli Suvranu, Gunn Andrew J, Kendi A Tuba, Khaja Minhajuddin S, Obara Piotr, Reis Stephen P, Vijay Kanupriya, Dill Karin E
Research Author, UT Southwestern Medical Center, Dallas, Texas.
UT Southwestern Medical Center, Dallas, Texas.
J Am Coll Radiol. 2019 May;16(5S):S2-S6. doi: 10.1016/j.jacr.2019.02.005.
Abdominal aortic aneurysm (AAA) is defined as aneurysmal dilation of the abdominal aorta to 3 cm or greater. A high degree of morbidity and mortality is associated with AAA rupture, and imaging surveillance plays an essential role in mitigating the risk of rupture. Aneurysm size and growth rate are factors associated with the risk of rupture, thus surveillance imaging studies must be accurate and reproducible to characterize aneurysm size. Ultrasound, CT angiography, and MR angiography provide an accurate and reproducible assessment of size, while radiographs and aortography provide limited evaluation. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
腹主动脉瘤（AAA）被定义为腹主动脉的动脉瘤样扩张至3厘米或更大。AAA破裂会导致高度的发病率和死亡率，而影像学监测在降低破裂风险方面起着至关重要的作用。动脉瘤大小和生长速度是与破裂风险相关的因素，因此监测影像学研究必须准确且可重复，以确定动脉瘤大小。超声、CT血管造影和MR血管造影可对大小进行准确且可重复的评估，而X线片和主动脉造影的评估有限。美国放射学会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年进行审查。指南的制定和修订包括对同行评审期刊上当前医学文献的广泛分析，以及应用成熟的方法（兰德/加州大学洛杉矶分校适宜性方法和推荐分级评估、制定与评价或GRADE）来评估特定临床场景下影像学和治疗程序的适宜性。在缺乏证据或证据不明确的情况下，专家意见可补充现有证据以推荐影像学检查或治疗方法。
