Stanford University Medical Center, Stanford, California.
Research Author, Stanford University Medical Center, Stanford, California.
J Am Coll Radiol. 2023 Nov;20(11S):S513-S520. doi: 10.1016/j.jacr.2023.08.010.
Abdominal aortic aneurysm (AAA) is defined as abnormal dilation of the infrarenal abdominal aortic diameter to 3.0 cm or greater. The natural history of AAA consists of progressive expansion and potential rupture. Although most AAAs are clinically silent, a pulsatile abdominal mass identified on physical examination may indicate the presence of an AAA. When an AAA is suspected, an imaging study is essential to confirm the diagnosis. This document reviews the relative appropriateness of various imaging procedures for the initial evaluation of suspected AAA. 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 process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
腹主动脉瘤（AAA）定义为肾下腹部主动脉直径异常扩张至 3.0cm 或更大。AAA 的自然病程包括进行性扩张和潜在破裂。尽管大多数 AAA 是临床无症状的，但体检时发现的搏动性腹部肿块可能表明存在 AAA。当怀疑 AAA 时，需要进行影像学检查以明确诊断。本文回顾了各种影像学检查程序在疑似 AAA 初始评估中的相对适宜性。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。指南的制定和修订过程支持对同行评议期刊的医学文献进行系统分析。既定的方法学原则，如推荐评估、制定和评估分级或 GRADE，被用于评估证据。RAND/UCLA 适宜性方法用户手册提供了用于确定特定临床情况下影像学和治疗程序适宜性的方法。在缺乏或存在争议的同行评议文献的情况下，专家可能是制定建议的主要可用证据来源。
