Director, Head and Neck Imaging, University of California Los Angeles, Los Angeles, California.
Panel Chair and Program Director, Diagnostic Radiology Residency Program, Montefiore Medical Center, Bronx, New York.
J Am Coll Radiol. 2021 Nov;18(11S):S283-S304. doi: 10.1016/j.jacr.2021.08.012.
Cerebrovascular disease is a broad topic. This document focuses on the imaging recommendations for the varied clinical scenarios involving intracranial aneurysms, vascular malformations, and vasculitis, which all carry high risk of morbidity and mortality. Additional imaging recommendations regarding complications of these conditions, including subarachnoid hemorrhage and vasospasm, are also covered. While each variant presentation has unique imaging recommendations, the major focus of this document is neurovascular imaging techniques. 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.
脑血管病是一个广泛的话题。本文重点介绍了涉及颅内动脉瘤、血管畸形和血管炎的各种临床情况的影像学建议，这些情况都有很高的发病率和死亡率。本文还涵盖了这些疾病并发症的其他影像学建议，包括蛛网膜下腔出血和血管痉挛。虽然每种变异表现都有独特的影像学建议，但本文的主要重点是神经血管成像技术。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上的现有医学文献进行广泛分析，并应用成熟的方法（RAND/UCLA 适宜性方法和推荐评估、制定和评估分级或 GRADE）对特定临床情况下的影像学和治疗程序的适宜性进行评分。在缺乏证据或证据存在争议的情况下，专家意见可以补充现有证据，以推荐影像学或治疗。
