Suspected Pulmonary Embolism

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Revised 2016 American College of Radiology ACR Appropriateness Criteria® Suspected Pulmonary Embolism   Variant 1:                         Suspected pulmonary embolism. Intermediate probability with a negative D-dimer or low pretest probability.   Radiologic Procedure Rating Comments RRL* X-ray chest 9 ☢ This procedure should be optimized for pulmonary arterial enhancement. This CTA chest with IV contrast 5 procedure […]

Suspected Infective Endocarditis

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Date of origin: 1998 Last review date: 2014 American College of Radiology ACR Appropriateness Criteria® Clinical Condition: Suspected Infective Endocarditis Radiologic Procedure Rating Comments RRL* US echocardiography transthoracic resting 9 This is the preferred modality. O X-ray chest 8 This procedure is useful for monitoring ☢ cardiopulmonary status. US echocardiography transesophageal 8 This invasive procedure […]

Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded)

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Date of origin: 2013 American College of Radiology ACR Appropriateness Criteria® Clinical Condition: Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded) Variant 1: Suspected arrhythmogenic cardiomyopathy. Radiologic Procedure Rating Comments RRL* MRI heart function and morphology 9 O without and with IV contrast US echocardiography transthoracic resting 8 O MRI heart function and […]

Known or Suspected Congenital Heart Disease in the Adult

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Revised 2016 American College of Radiology ACR Appropriateness Criteria® Known or Suspected Congenital Heart Disease in the Adult Variant 1: Known or suspected congenital heart disease in the adult. Radiologic Procedure Rating Comments RRL* X-ray chest 9 This is usually the first imaging ☢ procedure performed. US echocardiography transthoracic resting 9 This is usually one […]

Imaging for Transcatheter Aortic Valve Replacement

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Date of origin: 2013 American College of Radiology ACR Appropriateness Criteria®   Clinical Condition:         Imaging for Transcatheter Aortic Valve Replacement   Variant 1:                         Pre-intervention planning at the aortic valve plane.   Radiologic Procedure Rating Comments RRL* CTA chest with IV contrast 9 ☢☢☢ US echocardiography transesophageal 8 O US echocardiography transthoracic resting 7 O MRI […]

Dyspnea due to heart failure. Ischemia not excluded.

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Revised 2016 American College of Radiology ACR Appropriateness Criteria® Dyspnea–Suspected Cardiac Origin Variant 1: Dyspnea due to heart failure. Ischemia not excluded. Radiologic Procedure Rating Comments RRL* X-ray chest 9 ☢ US echocardiography transthoracic resting 9 O US echocardiography transthoracic stress 9 O Tc-99m SPECT MPI rest and stress 9 ☢ ☢ ☢ ☢ Rb-82 […]

Chronic Chest Pain — Low to Intermediate Probability of Coronary Artery Disease

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Date of origin: 1998 American College of Radiology Last review date: 2012 ACR Appropriateness Criteria® Clinical Condition: Chronic Chest Pain — Low to Intermediate Probability of Coronary Artery Disease Radiologic Procedure Rating Comments RRL* X-ray chest 9 ☢ US echocardiography transthoracic stress 8 To exclude ischemic cardiac disease. O Tc-99m SPECT MPI rest and stress […]

Chest Pain Suggestive of Acute Coronary Syndrome

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American College of Radiology ACR Appropriateness Criteria® Clinical Condition: Chest Pain Suggestive of Acute Coronary Syndrome Radiologic Procedure Rating Comments RRL* This procedure is appropriate for Tc-99m SPECT MPI rest and stress 8 intermediate-to-high likelihood for ☢ ☢ ☢ ☢ coronary artery disease. There is abundant literature available on clinical utility. Arteriography coronary 8 This […]

Asymptomatic Patient at Risk for Coronary Artery Disease

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American College of Radiology ACR Appropriateness Criteria® Clinical Condition: Asymptomatic Patient at Risk for Coronary Artery Disease Variant 1: Low risk. Radiologic Procedure Rating Comments RRL* CT coronary calcium 3 In patients with strong family history, this ☢☢☢ study may be of value. Fluoroscopy heart 2 ☢☢ US echocardiography transthoracic resting 2 O X-ray chest […]

Acute Nonspecific Chest Pain—Low Probability of Coronary Artery Disease

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American College of Radiology ACR Appropriateness Criteria® Clinical Condition: Acute Nonspecific Chest Pain—Low Probability of Coronary Artery Disease Radiologic Procedure Rating Comments RRL* X-ray, CTA, and US are generally ☢ X-ray chest 9 nonoverlapping and can be used sequentially. X-ray, CTA, and US are generally ☢☢☢ CTA coronary arteries with IV contrast 7 nonoverlapping and […]