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《2025年大动脉炎影像学诊断与评估中国指南》

2025 Chinese guideline for the imaging diagnosis and evaluation of Takayasu arteritis.

作者信息

Liu Yun, Ma Lingying, Zhang Zhuoli, Zhao Yan, Deng Xuerong, Lin Jiang, Qiu Jianxing, Shi Hongcheng, Wang Ke, Chen Zhu, Dai Lie, Dong Lingli, Feng Xuebing, He Lan, Huang Wenhui, Li Fen, Li Guangtao, Li Qin, Li Ting, Li Yisha, Lin Jin, Lin Jinying, Qi Wufang, Shen Haili, Shi Xiaofei, Shu Qiang, Tan Wenfeng, Wang Caihong, Wei Wei, Wu Huaxiang, Wu Lijun, Xie Qibing, Yang Pingting, Zhang Liyun, Zhao Ling, Zheng Zhaohui, Zheng Wenjie, Zhu Jing, Zhu Xiaochun, Wang Xiaoqin, Ying Jun, Jiang Lindi

机构信息

Department of Rheumatology and Immunology, Zhongshan Hospital, Fudan University, Shanghai, PR China.

Department of Rheumatology and Immunology, Peking University First Hospital, Beijing, PR China.

出版信息

Adv Rheumatol. 2025 Jun 3;65(1):25. doi: 10.1186/s42358-025-00460-9.

Abstract

BACKGROUND

Takayasu arteritis (TAK) presents as systemic vasculitis. Imaging is crucial for the diagnosis and evaluation of TAK, but the rational selection of imaging methods and interpretation of imaging results are major challenges in clinical practice, which can affect treatment decisions. This guideline aims to establish standardized protocols for selecting imaging modalities (as well as interpreting their findings) in TAK.

METHODS

Relevant clinical questions were formulated by an expert panel. Systematic reviews of evidence published from database establishment to 31 October 2023 were done. The grading system set by the Oxford University Evidence-Based Medicine Center was employed to assess the quality of evidence. Recommendations were developed through consensus using the Delphi method.

RESULTS

Seventeen recommendation statements were developed based on evidence summaries and consensus. The first four recommendations focused on overarching principles. Recommendations 5 to 14 covered the advantages and disadvantages of different imaging modalities, as well as the selection of imaging modalities in the diagnosis and evaluation of TAK, including ultrasound (three statements), magnetic resonance angiography (two), computed tomography angiography (two), positron emission tomography/computed tomography (two), and digital subtraction angiography (one). Recommendations 15 to 17 focused on the selection of imaging methods for special populations and organ perfusion.

CONCLUSION

These recommendations could help to standardize the use of imaging modalities by clinicians in the diagnosis and evaluation of TAK.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

大动脉炎(TAK)表现为系统性血管炎。影像学检查对于TAK的诊断和评估至关重要,但在临床实践中,合理选择影像学检查方法以及解读影像学结果是主要挑战,这可能会影响治疗决策。本指南旨在制定TAK影像学检查方式选择(以及解读其结果)的标准化方案。

方法

由一个专家小组提出相关临床问题。对从数据库建立至2023年10月31日发表的证据进行系统评价。采用牛津大学循证医学中心设定的分级系统评估证据质量。通过德尔菲法经共识形成推荐意见。

结果

基于证据总结和共识制定了17条推荐声明。前四条推荐聚焦于总体原则。推荐5至14涵盖了不同影像学检查方式的优缺点,以及TAK诊断和评估中影像学检查方式的选择,包括超声(三条声明)、磁共振血管造影(两条)、计算机断层血管造影(两条)、正电子发射断层扫描/计算机断层扫描(两条)和数字减影血管造影(一条)。推荐15至17聚焦于特殊人群和器官灌注的影像学检查方法选择。

结论

这些推荐意见有助于临床医生在TAK诊断和评估中规范使用影像学检查方式。

临床试验编号

不适用。

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