ACR Appropriateness Criteria® Suspected Upper Extremity Deep Vein Thrombosis.

{"article_title":"ACR Appropriateness Criteria\u00ae Suspected Upper Extremity Deep Vein Thrombosis.","author":"Desjardins B, Hanley M, Steigner ML, Aghayev A, Azene EM, Bennett SJ, Chandra A, Hedgire SS, Lo BM, Mauro DM, Ptak T, Singh-Bhinder N, Suranyi PS, Verma N, Dill KE","journal_title":"Journal of the American College of Radiology : JACR","issn":"1558-349X","isbn":"","publication_date":"2020-05-01","volume":"17","issue":"5S","first_page":"S315","page_count":"","accession_number":"32370975","doi":"10.1016\/j.jacr.2020.01.020","publisher":"Elsevier","doctype":"Practice Guideline","subjects":"United States; Upper Extremity Deep Vein Thrombosis diagnostic imaging; Computed Tomography Angiography; Diagnostic Imaging; Humans; Societies, Medical; United States; Upper Extremity diagnostic imaging","interest_area":["Internal Medicine"," Cardiology"," Emergency Medicine"],"abstract":"This publication includes the appropriate imaging modalities to assess suspected deep vein thrombosis in the upper extremities. Ultrasound duplex Doppler is the most appropriate imaging modality to assess upper-extremity deep vein thrombosis. It is a noninvasive test, which can be performed at the bedside and used for serial evaluations. Ultrasound can also directly identify thrombus by visualizing echogenic material in the vein and by lack of compression of the vein walls from manual external pressure. It can indirectly identify thrombus from altered blood-flow patterns. It is most appropriate in the evaluation of veins peripheral to the brachiocephalic vein. CT venography and MR venography are not first-line imaging tests, but are appropriate to assess the central venous structures, or to assess the full range of venous structures from the hand to the right atrium. Catheter venography is appropriate if therapy is required. Radionuclide venography and chest radiography are usually not appropriate to assess upper-extremity deep vein thrombosis. 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. Copyright \u00a9 2020 American College of Radiology. Published by Elsevier Inc. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=32370975","isPdfLink":false,"isSAML":false,"an":"32370975","number_other":"","type_pub":"","issn_electronic":"1558-349X","languages":"English","language":"eng","date_entry":"Date Created: 20200507 Date Completed: 20210621 Latest Revision: 20231129","date_update":"20240105","titleSource":"Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2020 May; Vol. 17 (5S), pp. S315-S322.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2020-05-01","description":"This publication includes the appropriate imaging modalities to assess suspected deep vein thrombosis in the upper extremities. Ultrasound duplex Doppler is the most appropriate imaging modality to assess upper-extremity deep vein thrombosis. It is a noninvasive test, which can be performed at the bedside and used for serial evaluations. Ultrasound can also directly identify thrombus by visualizing echogenic material in the vein and by lack of compression of the vein walls from manual external pressure. It can indirectly identify thrombus from altered blood-flow patterns. It is most appropriate in the evaluation of veins peripheral to the brachiocephalic vein. CT venography and MR venography are not first-line imaging tests, but are appropriate to assess the central venous structures, or to assess the full range of venous structures from the hand to the right atrium. Catheter venography is appropriate if therapy is required. Radionuclide venography and chest radiography are usually not appropriate to assess upper-extremity deep vein thrombosis. 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.<br \/> (Copyright © 2020 American College of Radiology. Published by Elsevier Inc. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=32370975&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Desjardins B, Hanley M, Steigner ML, Aghayev A, Azene EM, Bennett SJ, Chandra A, Hedgire SS, Lo BM, Mauro DM, Ptak T, Singh-Bhinder N, Suranyi PS, Verma N, Dill KE"}