ACR Appropriateness Criteria® Abnormal Liver Function Tests.
| Autor: | Arif-Tiwari H; University of Arizona, Banner University Medical Center, Tucson, Arizona. Electronic address: hinaarif@arizona.edu., Porter KK; University of Alabama Medical Center, Birmingham, Alabama., Kamel IR; Panel Chair, Johns Hopkins University School of Medicine, Baltimore, Maryland., Bashir MR; Duke University Medical Center, Durham, North Carolina., Fung A; Oregon Health & Science University, Portland, Oregon., Kaplan DE; Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; American Association for the Study of Liver Diseases., McGuire BM; University of Alabama at Birmingham, Birmingham, Alabama, Primary care physician., Russo GK; University of Connecticut, Farmington, Connecticut., Smith EN; University of Alabama at Birmingham Medical Center, Birmingham, Alabama., Solnes LB; Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Commission on Nuclear Medicine and Molecular Imaging., Thakrar KH; NorthShore University HealthSystem, Evanston, Illinois., Vij A; New York University Langone Medical Center, New York, New York., Wahab SA; University of Cincinnati Medical Center, Cincinnati, Ohio., Wardrop RM 3rd; Cleveland Clinic, Cleveland, Ohio; American College of Physicians, Hospital Medicine., Zaheer A; Johns Hopkins Hospital, Baltimore, Maryland., Carucci LR; Specialty Chair, Virginia Commonwealth University Medical Center, Richmond, Virginia. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2023 Nov; Vol. 20 (11S), pp. S302-S314. |
| DOI: | 10.1016/j.jacr.2023.08.023 |
| Abstrakt: | Liver function tests are commonly obtained in symptomatic and asymptomatic patients. Various overlapping lab patterns can be seen due to derangement of hepatocytes and bile ducts function. Imaging tests are pursued to identify underlying etiology and guide management based on the lab results. Liver function tests may reveal mild, moderate, or severe hepatocellular predominance and can be seen in alcoholic and nonalcoholic liver disease, acute hepatitis, and acute liver injury due to other causes. Cholestatic pattern with elevated alkaline phosphatase with or without elevated γ-glutamyl transpeptidase can be seen with various causes of obstructive biliopathy. Acute or subacute cholestasis with conjugated or unconjugated hyperbilirubinemia can be seen due to prehepatic, intrahepatic, or posthepatic causes. We discuss the initial and complementary imaging modalities to be used in clinical scenarios presenting with abnormal liver function tests. 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. (Copyright © 2023 American College of Radiology. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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