CT abdomen (summary)

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This is a basic article for medical students and other non-radiologists

CT abdomen is an increasingly common investigation that is used to help make diagnoses of a broad range of pathologies. A CT abdomen in its simplest form is a CT from diaphragm to symphysis pubis performed 60 seconds after pump-injection of iodinated contrast into a peripheral vein. However, depending on the clinical question, a variety of different protocols can be used.

Reference article

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Summary

  • indications
  • important pathology
  • benefits
    • relatively quick and accessible
    • reproducible findings
    • complete assessment of the abdomen and pelvis
  • limitations
    • uses ionizing radiation
      • risk of radiation-induced cancer
      • approximately 100 times the dose of a chest radiograph
    • requires iodinated IV contrast
      • risk of renal impairment
      • risk of anaphylactic reaction
  • procedure
    • check renal function
    • lie patient supine on CT table
    • scout image to plan study
    • IV contrast injected via pump-injector
    • 60-second delay
    • scan from dome of diaphragms to symphysis pubis
  • variations on a theme
    • differing the IV contrast injection and timing may be useful
      • dual-phase CT abdomen
        • two scans (one arterial and one portovenous)
        • assessment of vascular supply and parenchyma
      • dual-bolus CT abdomen
        • two injections of contrast
        • single scan of the abdomen
        • great in trauma and oncology imaging
      • CT pancreas
        • 3-phase non-contrast, arterial and portovenous

Similar tests

  • US abdomen
    • useful for assessment of liver, kidneys and biliary system
    • dependent on operator and patient body habitus
  • CT angiogram
    • vascular assessment of the arterial tree only
  • non-contrast CT abdomen
    • used when contrast is contraindicated
    • used for the assessment of renal stones, e.g. CT KUB or characterizing adrenal lesions
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