Abstract：
This review focuses on the initial imaging in the reproductive age adult population with acute pelvic pain, including patients with positive and negative beta-human chorionic gonadotropin (β-hCG) levels with suspected gynecological and nongynecological etiology. For all patients, a combination of transabdominal and transvaginal pelvic ultrasound with Doppler is usually appropriate as an initial imaging study. If nongynecological etiology in patients with negative β-hCG is suspected, then CT of the abdomen and pelvis with or without contrast is also usually appropriate. In patients with positive β-hCG and suspected nongynecological etiology, CT of the abdomen and pelvis with contrast and MRI of the abdomen and pelvis without contrast may be appropriate. In patients with negative β-hCG and suspected gynecological etiology, CT of the abdomen and pelvis with contrast, MRI of pelvis without contrast, or MRI of pelvis with and without contrast may be appropriate. 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 process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
摘要：
这篇综述集中在急性骨盆疼痛的育龄成年人群的初始成像，包括β-人绒毛膜促性腺激素（β-hCG）水平阳性和阴性的患者，怀疑是妇科和非妇科病因。对于所有患者来说，经腹和经阴道盆腔超声与多普勒的组合通常适合作为初始影像学研究。如果怀疑β-hCG阴性患者的非遗传学病因，然后腹部和骨盆的CT有或没有对比通常也是合适的。在β-hCG阳性且怀疑非神经病因学的患者中，腹部和骨盆的CT造影和腹部和骨盆的MRI无造影可能是合适的。在β-hCG阴性和疑似妇科病因的患者中，腹部和骨盆的CT对比，骨盆MRI无造影,或MRI骨盆有和没有对比可能是合适的。美国放射学会适当性标准是针对特定临床状况的循证指南，每年由多学科专家小组审查。指南的制定和修订过程支持对同行评审期刊的医学文献进行系统分析。既定的方法论原则，如建议评估分级，发展,评估或等级适用于评估证据。RAND/UCLA适当性方法用户手册提供了确定特定临床场景的成像和治疗程序适当性的方法。在那些缺乏同行评审文献或模棱两可的情况下，专家可能是制定建议的主要证据来源。
