Program Director, Radiology, University of Florida, Gainesville, Florida.
Panel Chair; and Director, Vascular CT/MR, and Medical Director, 3D Lab, Brigham & Women's Hospital, Boston, Massachusetts.
J Am Coll Radiol. 2021 Nov;18(11S):S482-S487. doi: 10.1016/j.jacr.2021.09.003.
The initial diagnosis of retroperitoneal bleeding can be challenging by physical examination and clinical presentation. Prompt imaging can make the diagnosis and be lifesaving. When selecting appropriate imaging for these patient's, consideration must be made for sensitivity and ability to image the retroperitoneum, as well as speed of imaging.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.
体格检查和临床表现可能使腹膜后出血的初步诊断具有挑战性。及时进行影像学检查有助于明确诊断并挽救生命。在为这些患者选择合适的影像学检查时，必须考虑其对腹膜后区域的敏感性和成像能力，以及成像速度。美国放射学院（ACR）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，并应用成熟的方法学（RAND/UCLA 适宜性方法和推荐评估、制定与评估分级或 GRADE）来评估特定临床情况下影像学检查和治疗程序的适宜性。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，以推荐影像学检查或治疗。
