根据ACR适当性标准®改变精神状态,昏迷,妄想和精神病:2024年更新
, Bruno P Soares1, Robert Y Shih2
1Stanford University School of Medicine, Stanford, California.
Journal of the American College of Radiology : JACR
|November 2, 2024
概括
改变精神状态 (AMS) 是一个常见的急诊室症状,而不是诊断. 本综述侧重于神经成像适用于新发狂妄或精神病的成年人,以排除紧急的内问题.
科学领域:
- 神经学 神经学
- 紧急医疗 紧急医疗
- 放射学 放射学是指放射学
背景情况:
- 改变精神状态 (AMS) 涵盖了一系列意识障碍,占急诊室主任投诉的4-10%.
- AMS是一种症状,而不是诊断,表明潜在的医疗,物质使用或心理健康状况.
- 常见的症状包括困惑,昏迷,兴奋,幻觉和精神病.
研究的目的:
- 评估神经成像在新发病改变精神状态,妄想或精神病的成年患者中的适当性.
- 引导临床决策,加速稳定和排除需要干预的内过程.
主要方法:
- 对同行评审的医学文献进行系统分析.
- 适应已建立的方法,如建议评估,开发和评估 (GRADE) 的评级.
- 在成像和治疗程序中使用RAND/UCLA适当性方法.
主要成果:
- 在新发疯或精神病的情况下,神经影像通常会加快,以排除新出现的内病理.
- 美国放射学学院的基于证据的指导方针每年都会审查适当性标准.
- 专家意见是当文献缺乏或模两可时的主要证据来源.
结论:
- 神经成像在改变精神状态的初始管理中起着至关重要的作用,特别是在新发作的妄想和精神病中.
- 这些指南旨在优化诊断策略和关键神经病情患者的护理.
- 适当使用神经成像可确保对危及生命的内疾病及时进行干预.
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