University of Alabama at Birmingham, Birmingham, Alabama, Director, Interventional Oncology, Director, Ambulatory Clinic, Assistant Program Director, Diagnostic Radiology Residency, Assistant Program Director, Interventional Radiology Residency, University of Alabama at Birmingham, Member, American College of Radiology-Radiologic Society of North America Patient Information Committee.
Panel Chair, Massachusetts General Hospital, Boston, Massachusetts, Chief, Division of Interventional Radiology, Massachusetts General Hospital.
J Am Coll Radiol. 2021 May;18(5S):S106-S118. doi: 10.1016/j.jacr.2021.02.004.
Nontraumatic aortic disease can be caused by a wide variety of disorders including congenital, inflammatory, infectious, metabolic, neoplastic, and degenerative processes. Imaging examinations such as radiography, ultrasound, echocardiography, catheter-based angiography, CT, MRI, and nuclear medicine examinations are essential for diagnosis, treatment planning, and assessment of therapeutic response. Depending upon the clinical scenario, each of these modalities has strengths and weaknesses. Whenever possible, the selection of a diagnostic imaging examination should be based upon the best available evidence. 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. The purpose of this document is to assist physicians select the most appropriate diagnostic imaging examination for nontraumatic aortic diseases.
非创伤性主动脉疾病可由多种疾病引起,包括先天性、炎症性、感染性、代谢性、肿瘤性和退行性病变。影像学检查,如放射摄影、超声、超声心动图、基于导管的血管造影、CT、MRI 和核医学检查,对于诊断、治疗计划和治疗反应评估至关重要。根据临床情况,这些方法各有优缺点。只要有可能,就应根据最佳现有证据选择诊断性影像学检查。美国放射学院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议期刊的现有医学文献进行广泛分析,并应用成熟的方法学(RAND/UCLA 适宜性方法和推荐评估、制定和评估分级或 GRADE)对特定临床情况的影像学和治疗程序的适宜性进行评分。在证据不足或存在争议的情况下,专家意见可以补充现有证据,以推荐影像学或治疗。本文件的目的是帮助医生为非创伤性主动脉疾病选择最合适的诊断性影像学检查。