Kim David H, Chang Kevin J, Fowler Kathryn J, Cash Brooks D, Garcia Evelyn M, Kambadakone Avinash R, Levy Angela D, Liu Peter S, Mace Sharon E, Marin Daniele, Moreno Courtney, Peterson Christine M, Pietryga Jason A, Solnes Lilja Bjork, Weinstein Stefanie, Carucci Laura R
Panel Chair, University of Wisconsin Hospital & Clinics, Madison, Wisconsin.
Newton-Wellesley Hospital, Newton, Massachusetts.
J Am Coll Radiol. 2020 May;17(5S):S81-S99. doi: 10.1016/j.jacr.2020.01.030.
Three common clinical scenarios involving use of imaging in Crohn disease are covered. These include the initial evaluation of Crohn disease when the diagnosis has not been previously established, the evaluation for anticipated exacerbation of known disease, and the evaluation of disease activity during therapy monitoring. The appropriateness of a given imaging modality for each scenario is rated as one of three categories (usually appropriate, may be appropriate, usually not appropriate) to help guide evaluation. Pediatric presentation of Crohn disease and the appropriateness of imaging are not covered in this document. 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.
本文涵盖了三种使用影像学检查克罗恩病的常见临床情况。这些情况包括在之前未确诊时对克罗恩病进行初步评估、对已知疾病预期加重情况的评估以及在治疗监测期间对疾病活动情况的评估。针对每种情况,特定影像学检查方式的适用性被评为三个类别之一(通常适用、可能适用、通常不适用),以帮助指导评估。本文未涉及克罗恩病的儿科表现及影像学检查的适用性。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,每年由多学科专家小组进行审查。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)来评定特定临床情况下影像学检查和治疗程序的适用性。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学检查或治疗方法。