Format

Send to

Choose Destination
J Am Coll Radiol. 2015 Oct;12(10):1048-57.e4. doi: 10.1016/j.jacr.2015.07.005.

ACR Appropriateness Criteria Crohn Disease.

Author information

1
University of Wisconsin Hospital and Clinics, Madison, Wisconsin. Electronic address: dkim@uwhealth.org.
2
Virginia Commonwealth University Medical Center, Richmond, Virginia.
3
Cleveland Clinic, Cleveland, Ohio.
4
University of South Alabama, Mobile, Alabama.
5
C.S. Mott Children's Hospital, Ann Arbor, Michigan.
6
University of Texas MD Anderson Cancer Center, Houston, Texas.
7
Mallinckrodt Institute of Radiology, Saint Louis, Missouri.
8
Johns Hopkins Hospital, Baltimore, Maryland.
9
Brown University Rhode Island Hospital, Providence, Rhode Island.
10
Beth Israel Deaconess Medical Center, Boston, Massachusetts.
11
Northwestern University, Chicago, Illinois.
12
University of California San Francisco, San Francisco, California.
13
Inland Imaging Associates and University of Washington, Seattle, Washington.

Abstract

Crohn disease is a chronic inflammatory disorder involving the gastrointestinal tract, characterized by episodic flares and times of remission. Underlying structural damage occurs progressively, with recurrent bouts of inflammation. The diagnosis and management of this disease process is dependent on several clinical, laboratory, imaging, endoscopic, and histologic factors. In recent years, with the maturation of CT enterography, and MR enterography, imaging has played an increasingly important role in relation to Crohn Disease. In addition to these specialized examination modalities, ultrasound and routine CT have potential uses. Fluoroscopy, radiography, and nuclear medicine may be less beneficial depending on the clinical scenario. The imaging modality best suited to evaluating this disease may change, depending on the target population, severity of presentation, and specific clinical situation. This document presents seven clinical scenarios (variants) in both the adult and pediatric populations and rates the appropriateness of the available imaging options. They are summarized in a consolidated table, and the underlying rationale and supporting literature are presented in the accompanying narrative. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

KEYWORDS:

Appropriateness Criteria; CT; Crohn disease; MR; imaging; ultrasound

PMID:
26435118
DOI:
10.1016/j.jacr.2015.07.005
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center