Title
ACR Appropriateness Criteria((R)) Imaging of Mesenteric Ischemia
UMMS Affiliation
Department of Radiology
Publication Date
2018-11-01
Document Type
Article
Disciplines
Radiology
Abstract
Mesenteric ischemia is an uncommon condition resulting from decreased blood flow to the small or large bowel in an acute or chronic setting. Acute ischemia is associated with high rates of morbidity and mortality; however, it is difficult to diagnose clinically. Therefore, a high degree of suspicion and prompt imaging evaluation are necessary. Chronic mesenteric ischemia is less common and typically caused by atherosclerotic occlusion or severe stenosis of at least two of the main mesenteric vessels. While several imaging examination options are available for the initial evaluation of both acute and chronic mesenteric ischemia, CTA of the abdomen and pelvis is overall the most appropriate choice for both conditions. 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 include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Keywords
AUC, Acute mesenteric ischemia, Appropriate Use Criteria, Appropriateness Criteria, CT angiography (CTA), Chronic mesenteric ischemia, Magnetic resonance angiography (MRA), Mesenteric angiogram, Ultrasound doppler
DOI of Published Version
10.1016/j.jacr.2018.09.018
Source
J Am Coll Radiol. 2018 Nov;15(11S):S332-S340. doi: 10.1016/j.jacr.2018.09.018. Link to article on publisher's site
Journal/Book/Conference Title
Journal of the American College of Radiology : JACR
Related Resources
PubMed ID
30392602
Repository Citation
Ginsburg, Michael; Obara, Piotr; Lambert, Drew L.; Hanley, Michael; Steigner, Michael L.; Camacho, Marc A.; Chandra, Ankur; Chang, Kevin J.; Gage, Kenneth L.; Peterson, Christine M.; Ptak, Thomas; Verma, Nupur; Kim, David H.; Carucci, Laura R.; and Dill, Karin E., "ACR Appropriateness Criteria((R)) Imaging of Mesenteric Ischemia" (2018). Radiology Publications and Presentations. 431.
https://escholarship.umassmed.edu/radiology_pubs/431