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ACR Appropriateness Criteria® Abnormal Uterine Bleeding
, Jessica B Robbins1, Elizabeth A Sadowski2
1Panel Vice-Chair, University of Wisconsin, Madison, Wisconsin.
For abnormal uterine bleeding, combined pelvic ultrasound with Doppler is the initial imaging choice. Further imaging like MRI or sonohysterography is guided by initial results and clinical suspicion for conditions like polyps.
Area of Science:
- Radiology
- Gynecology
- Medical Imaging
Background:
- Abnormal uterine bleeding (AUB) necessitates accurate imaging for diagnosis and management.
- Current literature review focuses on optimal imaging strategies for AUB patients.
Framework:
- Utilizes the American College of Radiology Appropriateness Criteria.
- Employs evidence-based guidelines developed through expert consensus and literature analysis.
- Incorporates methodologies like RAND/UCLA Appropriateness Method and GRADE.
Implementation:
- Recommends combined transabdominal and transvaginal pelvic ultrasound with Doppler as the primary imaging modality for AUB.
- Suggests pelvic MRI without and with contrast for incomplete ultrasound visualization.
- Proposes sonohysterography for suspected uterine polyps or as a follow-up assessment.
Implications:
- Provides a structured approach to imaging in AUB, improving diagnostic accuracy.
- Guides clinicians in selecting appropriate imaging studies based on clinical presentation and initial findings.
- Aims to optimize patient care and management of abnormal uterine bleeding through evidence-based recommendations.
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