非脑血管炎是一种影响血管的广泛非感染性炎症性疾病。根据血管大小对血管炎进行了分类,如大血管血管炎,中等血管血管炎,和小血管炎.在这份文件中,我们涵盖大血管血管炎和中等血管血管炎。由于血管活检的挑战,成像在诊断该实体中起着至关重要的作用。虽然CTA和MRA都可以提供血管壁的解剖细节,包括大血管血管炎的壁厚和增强,FDG-PET/CT可以显示基于发炎血管中炎性细胞的糖酵解活性的功能评估。考虑到中等血管血管炎的血管大小,侵入性动脉造影仍然是成像的一种选择。然而,高分辨率CTA图像可以描绘小口径动脉瘤,因此可用于中型血管炎的诊断。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。指南的制定和修订包括对同行评审期刊的当前医学文献的广泛分析以及完善的方法的应用(RAND/UCLA适当性方法和建议评估等级,发展,和评估或等级),以评估特定临床场景的成像和治疗程序的适当性。在缺乏证据或模棱两可的情况下,专家意见可以补充现有证据,推荐影像学检查或治疗。
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.