Division of Abdominal Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Zurich, Switzerland.
Abdom Radiol (NY). 2020 May;45(5):1338-1349. doi: 10.1007/s00261-019-02319-2.
In patients with acute pancreatitis (AP), diagnostic imaging is performed for various reasons, including the detection of the etiology (e.g., biliary obstruction caused by gallstones), diagnosis of pancreatitis in an unclear clinical setting, assessment of the severity of the process, and evaluation of its complications. In spite of the potential benefits of these imaging studies in the setting of AP, especially economic consequences but also medical risks are associated with diagnostic imaging, including increase of the effective radiation dose received by patients with AP and rising health care costs, frequently without impact on management. The rising incidence of acute pancreatitis in the Western world is escalating its financial burden with national health care expenses of over 2.5 billion dollars annually. Despite evidence-based national recommendations on utilization of diagnostic imaging in patients with AP, unnecessary imaging studies are still frequently performed, especially in the early hospital course. The purpose of this article is, therefore, to review the imaging guidelines for acute pancreatitis with regards to when and when not to image, with the aim to minimize inappropriate utilization.
在急性胰腺炎（AP）患者中，进行诊断影像学检查有多种原因，包括检测病因（例如，由胆结石引起的胆道阻塞）、在临床情况不明确时诊断胰腺炎、评估病情严重程度以及评估其并发症。尽管这些影像学研究在 AP 中的应用具有潜在的益处，特别是具有经济效益，但也与诊断影像学相关的医疗风险有关，包括增加 AP 患者接受的有效辐射剂量和不断上升的医疗保健费用，而这些通常对管理没有影响。急性胰腺炎在西方世界的发病率不断上升，使其经济负担不断加重，每年的国家医疗保健费用超过 25 亿美元。尽管有关于 AP 患者使用诊断影像学的循证国家建议，但仍经常进行不必要的影像学检查，尤其是在早期住院期间。因此，本文的目的是回顾急性胰腺炎的影像学指南，包括何时进行影像学检查和何时不进行影像学检查，以尽量减少不适当的使用。
