title: ACR appropriateness criteria jaundice.
abstract: A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 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 where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors: Inland Imaging Associates and University of Washington, Seattle, Washington, USA. tlalani@inlandimaging.com
authors: Tasneem
authors: T
authors: Lalani
authors: Corey A
authors: CA
authors: Couto
authors: Max P
authors: MP
authors: Rosen
authors: Mark E
authors: ME
authors: Baker
authors: Michael A
authors: MA
authors: Blake
authors: Brooks D
authors: BD
authors: Cash
authors: Jeff L
authors: JL
authors: Fidler
authors: Frederick L
authors: FL
authors: Greene
authors: Nicole M
authors: NM
authors: Hindman
authors: Douglas S
authors: DS
authors: Katz
authors: Harmeet
authors: H
authors: Kaur
authors: Frank H
authors: FH
authors: Miller
authors: Aliya
authors: A
authors: Qayyum
authors: William C
authors: WC
authors: Small
authors: Gary S
authors: GS
authors: Sudakoff
authors: Vahid
authors: V
authors: Yaghmai
authors: Gail M
authors: GM
authors: Yarmish
authors: Judy
authors: J
authors: Yee
mesh_terms: D002779:Cholestasis / Q000175:diagnosis* / Q000209:etiology*; D003952:Diagnostic Imaging / Q000592:standards*; D006801:Humans; D007565:Jaundice / Q000150:complications* / Q000175:diagnosis*; D011871:Radiology / Q000592:standards*; D014481:United States