ACR updates imaging guidance for renal and splanchnic artery aneurysms across four clinical scenarios

Updated ACR Appropriateness Criteria recommend CTA or MRA for nonpregnant adults with suspected or known renal/splanchnic artery aneurysms; ultrasound and noncontrast MRA are preferred in pregnancy to limit radiation and contrast exposure.

• Evidence-based guideline covering four scenarios: initial evaluation and surveillance in nonpregnant adults, plus initial evaluation and surveillance in pregnant patients — developed using GRADE methodology and RAND/UCLA expert consensus.
• CTA and MRA are generally considered 'usually appropriate' for nonpregnant adults; duplex Doppler, contrast-enhanced ultrasound, and noncontrast MRA are favored in pregnancy given radiation and gadolinium safety concerns.
• Key limitation: peer-reviewed literature on renal and splanchnic artery aneurysms is sparse in several scenarios, so expert opinion rather than high-quality trial data drives many recommendations.

RadPigeon summaries are original and for information only. They are not clinical advice.