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根据ACR的适当性标准®,急性左上象限疼痛
, Sahar Soleimani1, Ihab R Kamel2
1Research Author, Johns Hopkins Hospital, Baltimore, Maryland.
Journal of the American College of Radiology : JACR
|November 5, 2025
概括
左上象限 (LUQ) 腹部疼痛评估是具有挑战性的,因为非特异性症状和低考试协议. 本指导方针针对急性LUQ疼痛,怀疑脊髓大,推CT或超声波进行诊断.
科学领域:
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
- 紧急医疗 紧急医疗
背景情况:
- 急性腹痛是急诊室经常抱怨的一种情况.
- 左上象限 (LUQ) 疼痛带来了独特的诊断挑战,原因是身体检查的一致性低,以及非特异性症状.
- LUQ疼痛可以源于脏,LUQ感染,或从腹部器官转移疼痛.
研究的目的:
- 为评估急性左上象限 (LUQ) 腹部疼痛提供基于证据的指导方针,特别是在怀疑脊髓大病时.
- 为解决LUQ疼痛的诊断策略与发烧和不明原因.
- 根据临床表现概述适当的成像方法.
主要方法:
- 对同行评审的医学文献进行系统分析.
- 应用已确立的方法原则,如对建议的评价,开发和评估 (GRADE) 的评级.
- 使用RAND/UCLA适当性方法来评估成像程序.
主要成果:
- 腹部和骨盆的计算机断层扫描 (CT) 具有对比性,通常适用于广泛的病理检测.
- 腹部超声波是怀疑脊髓大病的患者初始成像的合适替代方案.
- 在文献证据有限的情况下,建议是基于专家的共识.
结论:
- 诊断成像,包括CT和超声波,在评估急性LUQ疼痛方面发挥着至关重要的作用.
- 美国放射学学院的适当性标准为适当的成像选择提供了一个框架.
- 专家意见在制定复杂或罕见的演示文稿的建议时是有价值的.
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