Weiss Clifford R, Bailey Christopher R, Hohenwalter Eric J, Pinchot Jason W, Ahmed Osmanuddin, Braun Aaron R, Cash Brooks D, Gupta Samir, Kim Charles Y, Knavel Koepsel Erica M, Scheidt Matthew J, Schramm Kristofer, Sella David M, Lorenz Jonathan M
Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
Research Author, Johns Hopkins Hospital, Baltimore, Maryland.
J Am Coll Radiol. 2020 May;17(5S):S265-S280. doi: 10.1016/j.jacr.2020.01.034.
Infected fluid collections are common and occur in a variety of clinical scenarios throughout the body. Minimally invasive image-guided management strategies for infected fluid collections are often preferred over more invasive options, given their low rate of complications and high rates of success. However, specific clinical scenarios, anatomic considerations, and prior or ongoing treatments must be considered when determining the optimal management strategy. As such, several common scenarios relating to infected fluid collections were developed using evidence-based guidelines for management. 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.
感染性液体积聚很常见，可发生于全身各种临床情况中。鉴于其并发症发生率低且成功率高，对于感染性液体积聚，微创影像引导下的管理策略通常比侵入性更强的选择更受青睐。然而，在确定最佳管理策略时，必须考虑特定的临床情况、解剖学因素以及既往或正在进行的治疗。因此，根据循证管理指南制定了几种与感染性液体积聚相关的常见情况。美国放射学会适宜性标准是针对特定临床状况的循证指南，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的当前医学文献进行广泛分析，并应用成熟的方法（兰德/加州大学洛杉矶分校适宜性方法以及推荐分级评估、制定与评价或GRADE）来评估特定临床情况下影像检查和治疗程序的适宜性。在证据不足或不明确的情况下，专家意见可补充现有证据以推荐影像检查或治疗。
