Journal of the American College of Radiology最新文献_第2页

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Palpable Abdominal Mass-Suspected Neoplasm 便于患者理解的 ACR 适宜性标准®摘要：可触及的腹部肿块-疑似肿瘤。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.07.014

Elizabeth M. McGuire MBA, MSc, BS , Luke Ledbetter MD

引用次数: 0

Reducing Delays in MRIs Under Sedation and General Anesthesia Using Quality Improvement Tools 利用质量改进工具减少镇静和全身麻醉下核磁共振成像的延迟。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.05.012

Aric Lee MBBS, FRCR (UK), MMed (Diagnostic Radiology) , Eunice Lee MBBS, MMed (Anaesthesia) , Shalini Nair Masters in Magnetic Resonance Technology (M.MRT) , Chi Yao Wang BSc , Jennifer Chong BSc , James Thomas Patrick Decourcy Hallinan MBChB (Hons), BSc (Hons), FRCR , Sophia Ang MBBS, MMed (Anaesthesia)

Objective

Develop structured, quality improvement interventions to achieve a 15%-point reduction in MRIs performed under sedation or general anesthesia (GA) delayed more than 15 min within a 6-month period.

Methods

A prospective audit of MRIs under sedation or GA from January 2022 to June 2023 was conducted. A multidisciplinary team performed process mapping and root cause analysis for delays. Interventions were developed and implemented over four Plan, Do, Study, Act (PDSA) cycles, targeting workflow standardization, preadmission patient counseling, reinforcing adherence to scheduled scan times and written consent respectively. Delay times (compared with Kruskal-Wallis and Dunn’s tests), delays more than 15 min and delays of 60 min or more at baseline and after each PDSA cycle were recorded.

Results

In all, 627 MRIs under sedation or GA were analyzed, comprising 443 at baseline and 184 postimplementation. Of the 627, 556 (88.7%) scans were performed under sedation, 22 (3.5%) under monitored anesthesia care, and 49 (7.8%) under GA. At baseline, 71.6% (317 of 443) scans were delayed over 15 min and 28.2% (125 of 443) scans by 60 min or more, with a median delay of 30 min. Postimplementation, there was a 34.7%-point reduction in scans delayed more than 15 min, a 17.5%-point reduction in scans delayed by 60 min or more, and a reduction in median delay time by 15 min (P < .001).

Discussion

Structured interventions significantly reduced delays in MRIs under sedation and GA, potentially improving outcomes for both patients and providers. Key factors included a diversity of perspectives in the study team, continued stakeholder engagement and structured quality improvement tools including PDSA cycles.

目标：制定结构化的质量改进（QI）干预措施，使在镇静或全身麻醉（GA）下进行的核磁共振成像在 6 个月内延迟超过 15 分钟的情况减少 15%：方法：对 2022 年 1 月至 2023 年 6 月期间在镇静或全身麻醉下进行的核磁共振成像进行前瞻性审计。一个多学科团队对延误进行了流程规划和根本原因分析。在四个 "计划、实施、研究、行动"（PDSA）周期内制定并实施了干预措施，分别针对工作流程标准化、入院前患者咨询、加强遵守预定扫描时间和书面同意。记录了基线和每个 PDSA 周期后的延迟时间（通过 Kruskal-Wallis 和 Dunn 检验进行比较）、超过 15 分钟的延迟时间和 60 分钟或以上的延迟时间：分析了在镇静或 GA 状态下进行的 627 次核磁共振成像，其中基线时 443 次，实施后 184 次。556/627（88.7%）次扫描是在镇静状态下进行的，22/627（3.5%）次是在监测麻醉护理下进行的，49/627（7.8%）次是在GA下进行的。基线时，71.6%（317/443）的扫描延迟了 15 分钟以上，28.2%（125/443）的扫描延迟了 60 分钟或以上，中位延迟时间为 30 分钟。实施干预后，延迟 15 分钟以上的扫描减少了 34.7%，延迟 60 分钟或以上的扫描减少了 17.5%，延迟时间中位数减少了 15 分钟（P 讨论）：结构化干预大大减少了镇静和 GA 下核磁共振成像的延迟，可能会改善患者和医疗服务提供者的治疗效果。关键因素包括研究团队的多元化观点、利益相关者的持续参与以及包括 PDSA 循环在内的结构化 QI 工具。

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引用次数: 0

ACR Appropriateness Criteria® Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass: 2024 Update ACR Appropriateness Criteria® 《急性发作性阴囊疼痛--无外伤、无前驱肿块：2024 年更新版》（ACR Appriateness Criteria® Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass: 2024 Update）。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.08.011

Expert Panel on Urological Imaging, Marielia Gerena MD , Brian C. Allen MD , Baris Turkbey MD , Samantha J. Barker MD , Daniel N. Costa MD , Carl Flink MD , Mariana L. Meyers MD , Ranjith Ramasamy MD , Javier Rosario MD , Akash Sharma MD, MBA , Pat Whitworth III MD , Winter L. Williams MD , Aytekin Oto MD

Acute scrotum is a medical emergency that requires prompt accurate diagnosis to appropriately triage potentially surgical conditions. Numerous differential diagnoses with overlapping clinical presentations make this a diagnostic challenge. Ultrasound is the established first-line imaging modality for acute scrotal disease and can be used to diagnose most scrotal disorders promptly and with high accuracy.

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.

急性阴囊炎是一种内科急症，需要及时做出准确诊断，以便对潜在的手术病症进行适当分流。众多的鉴别诊断和重叠的临床表现使诊断成为一项挑战。超声波是治疗急性阴囊疾病的公认一线成像方式，可用于及时、准确地诊断大多数阴囊疾病。美国放射学会适当性标准是针对特定临床病症的循证指南，每年由一个多学科专家小组进行审查。指南的制定和修订过程支持对同行评审期刊上的医学文献进行系统分析。既定的方法原则，如 "建议评估、发展和评价分级"（GRADE），被用来评估证据。兰德/加州大学洛杉矶分校《适宜性方法用户手册》提供了确定特定临床情况下成像和治疗程序适宜性的方法。在缺乏同行评议文献或文献模棱两可的情况下，专家可能是制定建议的主要证据来源。

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引用次数: 0

Assessing the Impact of Patient-Friendly Radiology Reports on Patient-Centered Outcomes Using Artificial Intelligence Sentiment Analysis 利用人工智能情感分析评估患者友好型放射学报告对以患者为中心的结果的影响。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.07.022

Ali Khader MD , Nicholas Befera MD , Ryan Short MD , Jalil Afnan MD , Christoph Wald MD, PhD

引用次数: 0

New Old Age Meets the Same Old Ageism: Leveraging Technology to Promote Healthier Aging 新老交替：利用技术促进更健康的老龄化。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.03.013

Amanda Rees BSE , Elliot K. Fishman MD , Linda C. Chu MD , Steven P. Rowe MD, PhD , Ryan C. Rizk MS

引用次数: 0

ACR Appropriateness Criteria® Tracheobronchial Disease ACR Appropriateness Criteria® 气管支气管疾病。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.08.015

Expert Panel on Thoracic Imaging, Brent P. Little MD , Christopher M. Walker MD , Tami J. Bang MD , Anupama G. Brixey MD , Jared D. Christensen MD, MBA , Jose De Cardenas MD , Stephen B. Hobbs MD , Alan Klitzke MD , Rachna Madan MBBS , Fabien Maldonado MD , M. Blair Marshall MD , William H. Moore MD , Edwin Rosas MD , Jonathan H. Chung MD

A variety of thoracic imaging modalities and techniques have been used to evaluate diseases of the trachea and central bronchi. This document evaluates evidence for the use of thoracic imaging in the evaluation of tracheobronchial disease, including clinically suspected tracheal or bronchial stenosis, tracheomalacia or bronchomalacia, and bronchiectasis. Appropriateness guidelines for initial imaging evaluation of tracheobronchial disease and for pretreatment planning or posttreatment evaluation are included.

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.

各种胸部成像模式和技术已被用于评估气管和中央支气管疾病。本文件评估了使用胸部成像评估气管支气管疾病的证据，包括临床上怀疑的气管或支气管狭窄、气管畸形或支气管畸形以及支气管扩张。其中包括气管支气管疾病初始成像评估、预处理计划或治疗后评估的适当性指南。美国放射学会适宜性标准是针对特定临床病症的循证指南，每年由一个多学科专家小组进行审查。指南的制定和修订过程支持对同行评审期刊上的医学文献进行系统分析。已确立的方法原则，如 "建议评估、发展和评价分级"（GRADE），被用来评估证据。兰德/加州大学洛杉矶分校《适宜性方法用户手册》提供了确定特定临床情况下成像和治疗程序适宜性的方法。在缺乏同行评议文献或文献模棱两可的情况下，专家可能是制定建议的主要证据来源。

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引用次数: 0

ACR Appropriateness Criteria® Introduction to the JACR Appropriateness Criteria November 2024 Supplement ACR 适宜性标准® JACR 适宜性标准 2024 年 11 月增补版简介。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.08.023

Ihab R. Kamel MD, PhD

引用次数: 0

Exploring the Effect of Domain-Specific Transfer Learning for Thyroid Nodule Classification 探索特定领域迁移学习对甲状腺结节分类的影响。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.06.011

Sanaz Vahdati MD , Bardia Khosravi MD, MPH, MHPE , Pouria Rouzrokh MD, MPH, MHPE , Bradley J. Erickson MD, PhD

引用次数: 0

Diagnostic Radiology Continues to Fail to Capture the Preliminary Year 放射诊断学仍然未能抓住初年的机遇。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.06.022

Kevin Vo BS , Garrett Trang BS , Ami Gokli MD , Cory M. Pfeifer MD, MBA, MPH, MS

引用次数: 0

ACR Appropriateness Criteria® Thoracic Back Pain ACR Appropriateness Criteria® 胸背部疼痛。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-11-01 DOI: 10.1016/j.jacr.2024.08.016

Expert Panel on Neurological Imaging, Vinil N. Shah MD , Matthew S. Parsons MD , Daniel J. Boulter MD , Judah Burns MD , Brian Callaghan MD, MS , Rami Eldaya MD , Michael Hanak MD , Alvand Hassankhani MD , Troy A. Hutchins MD , Christopher D. Jackson MD , Majid A. Khan MD , Jeff Mullin MD, MBA , A. Orlando Ortiz MD, MBA , Charles Reitman MD , Christopher Sampson MD , Claire K. Sandstrom MD , Vincent M. Timpone MD , Andrew T. Trout MD , Bruno Policeni MD, MBA

Thoracic back pain is a common site for inflammatory, neoplastic, metabolic, infectious, and degenerative conditions, and may be associated with significant disability and morbidity. Uncomplicated acute thoracic back pain and/or radiculopathy does not typically warrant imaging. Imaging may be considered in those patients who have persistent pain despite 6 weeks of conservative treatment. Early imaging may also be warranted in patients presenting with “red flag” history or symptoms, including those with a known or suspected history of cancer, infection, immunosuppression, or trauma; in myelopathic patients; or in those with a history of prior thoracic spine fusion.

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.

胸背部疼痛是炎症、肿瘤、代谢、感染和退行性病变的常见部位，可能会导致严重的残疾和发病。无并发症的急性胸背部疼痛和/或根性病变通常不需要进行造影检查。在保守治疗 6 周后仍有持续疼痛的患者可考虑进行造影检查。对于有 "危险 "病史或症状的患者，包括已知或怀疑有癌症、感染、免疫抑制或外伤病史的患者；骨髓病患者；或既往有胸椎融合术病史的患者，也应及早进行造影检查。美国放射学会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进行审查。指南的制定和修订过程支持对同行评审期刊上的医学文献进行系统分析。已确立的方法原则，如 "建议评估、发展和评价分级"（GRADE），被用来评估证据。兰德/加州大学洛杉矶分校《适宜性方法用户手册》提供了确定特定临床情况下成像和治疗程序适宜性的方法。在缺乏同行评议文献或文献模棱两可的情况下，专家可能是制定建议的主要证据来源。

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引用次数: 0