TY - JOUR
T1 - ACR Appropriateness Criteria® Noncerebral Vasculitis
AU - Expert Panel on Vascular Imaging:
AU - Aghayev, Ayaz
AU - Steigner, Michael L.
AU - Azene, Ezana M.
AU - Burns, Judah
AU - Chareonthaitawee, Panithaya
AU - Desjardins, Benoit
AU - El Khouli, Riham H.
AU - Grayson, Peter C.
AU - Hedgire, Sandeep S.
AU - Kalva, Sanjeeva P.
AU - Ledbetter, Luke N.
AU - Lee, Yoo Jin
AU - Mauro, David M.
AU - Pelaez, Andres
AU - Pillai, Anil K.
AU - Singh, Nimarta
AU - Suranyi, Pal S.
AU - Verma, Nupur
AU - Williamson, Eric E.
AU - Dill, Karin E.
N1 - Publisher Copyright:
© 2021 American College of Radiology
PY - 2021/11
Y1 - 2021/11
N2 - Noncerebral vasculitis is a wide-range noninfectious inflammatory disorder affecting the vessels. Vasculitides have been categorized based on the vessel size, such as large-vessel vasculitis, medium-vessel vasculitis, and small-vessel vasculitis. In this document, we cover large-vessel vasculitis and medium-vessel vasculitis. Due to the challenges of vessel biopsy, imaging plays a crucial role in diagnosing this entity. While CTA and MRA can both provide anatomical details of the vessel wall, including wall thickness and enhancement in large-vessel vasculitis, FDG-PET/CT can show functional assessment based on the glycolytic activity of inflammatory cells in the inflamed vessels. Given the size of the vessel in medium-vessel vasculitis, invasive arteriography is still a choice for imaging. However, high-resolution CTA images can depict small-caliber aneurysms, and thus can be utilized in the diagnosis of medium-vessel vasculitis. 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.
AB - Noncerebral vasculitis is a wide-range noninfectious inflammatory disorder affecting the vessels. Vasculitides have been categorized based on the vessel size, such as large-vessel vasculitis, medium-vessel vasculitis, and small-vessel vasculitis. In this document, we cover large-vessel vasculitis and medium-vessel vasculitis. Due to the challenges of vessel biopsy, imaging plays a crucial role in diagnosing this entity. While CTA and MRA can both provide anatomical details of the vessel wall, including wall thickness and enhancement in large-vessel vasculitis, FDG-PET/CT can show functional assessment based on the glycolytic activity of inflammatory cells in the inflamed vessels. Given the size of the vessel in medium-vessel vasculitis, invasive arteriography is still a choice for imaging. However, high-resolution CTA images can depict small-caliber aneurysms, and thus can be utilized in the diagnosis of medium-vessel vasculitis. 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.
KW - AUC
KW - Appropriate Use Criteria
KW - Appropriateness Criteria
KW - Giant cell arteritis
KW - Kawasaki disease
KW - Large-vessel vasculitis
KW - Medium-vessel vasculitis
KW - Polyarteritis nodosa
KW - Takayasu's arteritis
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U2 - 10.1016/j.jacr.2021.08.005
DO - 10.1016/j.jacr.2021.08.005
M3 - Article
C2 - 34794595
AN - SCOPUS:85119068683
SN - 1546-1440
VL - 18
SP - S380-S393
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 11
ER -