ACR 适当性标准®：疑似膈肌功能障碍。
完整摘要 · 中文译文
膈肌功能障碍包括膈肌膨升、膈肌无力和膈肌麻痹，这类疾病常因症状表现多样（包括呼吸困难、体位性端坐呼吸、咳嗽，甚至胸痛）而在临床诊断上具有挑战性。鉴于这些疾病在临床诊断上的困难，膈肌功能障碍常在对这些症状进行初步影像学检查时被偶然提示。影像学在提出膈肌功能障碍的初步怀疑以及通过实时评估膈肌功能作出诊断方面均可发挥重要作用。本文档重点关注对疑似膈肌功能障碍的初步影像学检查，以确认诊断并评估导致功能障碍的潜在病因。美国放射学会适宜性标准是针对特定临床情况的循证指南，由多学科专家小组每年审查一次。指南制定和修订过程支持对同行评审期刊中的医学文献进行系统分析。采用既定方法学原则，如推荐分级的评估、制定与评价（GRADE），来评估证据。RAND/UCLA适宜性方法用户手册提供了确定特定临床情况下影像学和治疗程序适宜性的方法。在同行评审文献缺乏或证据不明确的情况下，专家意见可能是制定推荐意见的主要证据来源。
完整摘要 · 英文原文
Diaphragm dysfunction includes diaphragmatic eventration, weakness, and paralysis, a set of disorders which are often challenging to diagnose clinically due to their varied presenting symptoms including dyspnea, positional orthopnea, cough, or even chest pain. Given the clinical challenge in diagnosing these conditions, diaphragm dysfunction is often suggested incidentally on initial imaging for workup of these symptoms. Imaging can play an important role both in raising the initial suspicion for diaphragm dysfunction as well as in making the diagnosis through real-time evaluation of the diaphragm's function. This document focuses on the initial imaging of suspected diaphragm dysfunction to confirm the diagnosis and evaluate for underlying leading to the dysfunction. 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.