Portland VA Healthcare System and Oregon Health & Science University, Portland, Oregon.
Oregon Health & Science University, Portland, Oregon.
J Am Coll Radiol. 2024 Jun;21(6S):S292-S309. doi: 10.1016/j.jacr.2024.02.029.
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. A search for the underlying cause of infection typically includes radiological imaging as part of this investigation. This document focuses on thoracic and abdominopelvic causes of sepsis. In 2017, the global incidence of sepsis was estimated to be 48.9 million cases, with 11 million sepsis-related deaths (accounting for nearly 20% of all global deaths); therefore, understanding which imaging modalities and types of studies are acceptable or not acceptable is imperative. The 5 variants provided include the most commonly encountered scenarios in the setting of sepsis along with recommendations and data for each imaging study. 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.
脓毒症定义为宿主对感染的失调反应导致的危及生命的器官功能障碍。寻找感染的根本原因通常包括影像学检查作为该研究的一部分。本文重点介绍脓毒症的胸腹部和腹部病因。2017 年,全球脓毒症的发病率估计为 4890 万例,与脓毒症相关的死亡人数为 1100 万例(占全球所有死亡人数的近 20%);因此,了解哪些成像方式和类型的研究是可以接受的或不可接受的是至关重要的。提供的 5 种变体包括脓毒症背景下最常见的情况,以及对每种影像学研究的建议和数据。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、制定和评估或 GRADE 的分级,被用来评估证据。RAND/UCLA 适宜性方法用户手册提供了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证据来源。