英国妊娠期急性腹痛影像检查实践调查：BSUR与BSGAR全国调查
该调查于2025年5月至8月向BSUR和BSGAR会员发放电子问卷，共收到来自63家英国机构的91份回复，旨在描述妊娠期急性腹痛的影像可及性、检查路径与报告实践。结果显示超声和MRI在工作日工作时间可及性最高、其他时段下降，CT各时段可及性均保持95%以上，多数机构缺乏专用影像路径，知情同意与对比剂使用差异大；最高96%受访者认为正式指南有价值。
要点
- 妊娠期急性腹痛影像路径多数机构缺失，报告时需注意本院流程与知情同意差异。
- 超声与MRI非工作时间可及性下降，CT各时段可及性均保持95%以上。
- 最高96%受访者认为需要正式指南，提示实践差异普遍存在。
核心结论
- 英国妊娠期急性腹痛影像在可及性、检查路径、知情同意、对比剂使用及报告责任方面存在机构间和时段间差异，亟需BSUR、BSGAR与RCR联合指南规范。
研究设计与样本
- 研究类型为全国性匿名电子问卷调查，于2025年5月至8月发放给BSUR和BSGAR会员。
- 共收到91份回复，来自63家英国机构。
- 问卷内容涵盖设备可及性、影像路径、知情同意、CT与MRI技术及报告安排。
- 参考标准为受访者自报的机构实践，非患者层面影像与病理对照。
临床应用与阅片要点
- 阅片和报告时应了解本院妊娠期急性腹痛影像路径是否存在及非工作时间设备可及性。
- 关注CT和MRI对比剂使用、剂量方案与报告责任在机构和时段间的差异，报告时明确检查条件。
- 知情同意与患者信息实践差异大，建议在报告或沟通中记录相关讨论要点。
局限性
- 研究为问卷自报实践，未与患者实际影像或临床结局对照。
- 仅收到91份回复、来自63家机构，可能不能完全代表全英国实践。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
AIM: Acute abdominal presentations in pregnancy (AAPP) are common and require rapid diagnostic decisions. Imaging plays a critical role, but concerns regarding fetal safety complicate decision-making. While international guidelines exist, no UK-specific guidance is currently available. To inform forthcoming UK guidance from BSUR, BSGAR, and RCR, a national survey was conducted to describe current imaging access, pathways and reporting practices.
MATERIALS AND METHODS: An electronic survey was distributed to BSUR and BSGAR members between May and August 2025. Questions addressed modality availability, imaging pathways, practicalities of imaging (including consent and CT and MRI techniques) and reporting arrangements. Responses were anonymous.
RESULTS: A total of 91 responses were received from 63 UK institutions. Access to ultrasound and MRI was highest during weekday "in-hours", declining at other times. CT access remained consistently high (>95% at all times). Formal imaging pathways for AAPP were limited, with the majority of institutions lacking dedicated protocols. Consent and patient information practices were highly variable. Use of contrast in MR/CT imaging varied, and supervision, dose protocols, and reporting responsibilities differed across institutions and time of day. Confidence in discussing imaging risks was moderate to high, yet up to 96% of respondents indicated that formal guidance would be valuable.
CONCLUSION: This national survey highlights variation in the imaging of AAPP across the UK, including access to imaging, pathways, and reporting. These findings underscore the need for clear guidance to support evidence-based imaging. Forthcoming joint BSUR, BSGAR, and RCR guidelines aim to address these gaps, promoting consistent, high-quality care for pregnant patients presenting with suspected acute abdominal pathology.
引用
- Wiles R, Cuthbert F, Balasubramaniam R, et al. Imaging acute abdominal presentations in pregnancy - a British society of urogenital radiology and British society of gastrointestinal and abdominal radiology survey of UK radiology practice. Clin Radiol. 2026. PMID: 42150284. doi:10.1016/j.crad.2026.107366
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。