Cleveland Clinic, Cleveland, Ohio.
Panel Chair, University of Michigan, Ann Arbor, Michigan.
J Am Coll Radiol. 2024 Nov;21(11S):S384-S395. doi: 10.1016/j.jacr.2024.08.017.
Endometriosis is a common condition impacting individuals assigned female at birth. Though incompletely understood, the disorder is caused by endometrial-like tissue located outside of the endometrial cavity, associated with inflammation and fibrosis. Clinical presentation is variable, ranging from asymptomatic to severe pelvic pain and infertility. Treatment is determined by the patient's individualized goals and can include medical therapies to temporize symptoms or definitive surgical excision. Imaging is used to help diagnose endometriosis and for treatment planning. 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.
子宫内膜异位症是一种常见的疾病,影响出生时被指定为女性的个体。尽管其发病机制尚未完全阐明,但这种疾病是由位于子宫内膜腔外的类似子宫内膜的组织引起的,与炎症和纤维化有关。临床表现多种多样,从无症状到严重的盆腔疼痛和不孕。治疗方法取决于患者的个体化目标,可以包括暂时缓解症状的药物治疗或明确的手术切除。影像学检查用于帮助诊断子宫内膜异位症和制定治疗计划。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上的医学文献进行系统分析。已确立的方法学原则,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情况下,同行评议文献,专家可能是制定建议的主要证据来源。