ACR Appropriateness Criteria Hearing Loss and/orVertigo.
ACR Appropriateness Criteria Hearing Loss and/orVertigo.
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DOI：
10.1016/j.jacr.2018.09.020
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发表时间：
2018-11-01
期刊：
影响因子：
--
通讯作者：
Bykowski, Julie
中科院分区：
文献类型：
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作者：
Sharma, Aseem;Kirsch, Claudia F E;Bykowski, Julie
本文介绍了对出现听力损失或眩晕的患者的影像应用指南，这些症状有时是由于感受器和负责听力和平衡的神经通路的接近而同时发生的。这些指南考虑到了CT在提供骨骼细节方面的优势和MRI提供的更好的软组织分辨率。应该指出的是，在这些患者中，专用的颞骨CT比头部CT更能准确地显示疾病。同样，最佳的评估通常需要一个专门的高分辨率方案来评估颞骨和内耳道，即使这样的研究将被要求并被标榜为脑MRI。血管造影技术对一些患者很有帮助，特别是在眩晕的情况下。美国放射学学会的适当性标准是针对特定临床情况的循证指南，每年由一个多学科专家小组审查。指南的制定和修订包括对同行评审期刊的当前医学文献进行广泛分析，并应用成熟的方法(兰德/加州大学洛杉矶分校的适当性方法和建议的评级评估、开发和评估或评级)来对特定临床场景的成像和治疗过程的适当性进行评级。在缺乏证据或证据不明确的情况下，专家意见可以补充现有证据，以建议进行成像或治疗。
This article presents guidelines for imaging utilization in patients presenting with hearing loss or vertigo, symptoms that sometimes occur concurrently due to proximity of receptors and neural pathways responsible for hearing and balance. These guidelines take into account the superiority of CT in providing bony details and better soft-tissue resolution offered by MRI. It should be noted that a dedicated temporal bone CT rather than a head CT best achieves delineation of disease in many of these patients. Similarly, optimal assessment often requires a dedicated high-resolution protocol designed to assess temporal bone and internal auditory canals even though such a study will be requested and billed as a brain MRI. Angiographic techniques are helpful in some patients, especially in the setting ofvertigo. 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.