Tailored helical CT evaluation of acute abdomen

Bruce A. Urban, Elliot K Fishman

Research output: Contribution to journalArticle

Abstract

Helical computed tomography (CT) allows rapid, cost-effective evaluation of patients with acute abdominal pain. Tailoring the examination to the working clinical diagnosis by optimizing constituent factors (eg, timing of acquisition, contrast material used, means and rate of contrast material administration, collimation, pitch) can markedly improve diagnostic accuracy. Rapid (≥3 mL/sec) intravenous injection of contrast material is required for optimal assessment of acute pancreatitis, ischémie bowel, aortic aneurysm, and aortic dissection. Narrow collimation and small reconstruction intervals can help detect calculi in the biliary system and genitourinary tract. Tailored helical CT in patients with acute pyelonephritis usually involves several acquisitions through the kidneys during various phases of renal enhancement. In patients with suspected renal infarction, CT protocol must include an acquisition during the corticomedullary phase. Helical CT with 5-mm collimation through the lower abdomen and pelvis is used to evaluate patients with suspected diverticulitis. Use of both oral and intravenous contrast material can help localize small bowel perforation and characterize related complications. Tailored helical CT for assessment of abdominal hemorrhage consists of initial unenhanced CT followed by optional contrast material-enhanced CT. Clear communication between the radiologist, the patient, and the referring physician is essential for narrowing the differential diagnosis into a working diagnosis prior to helical CT.

Original languageEnglish (US)
Pages (from-to)725-749
Number of pages25
JournalRadiographics : a review publication of the Radiological Society of North America, Inc
Volume20
Issue number3
StatePublished - May 2000

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Acute Abdomen
Spiral Computed Tomography
Contrast Media
Tomography
Kidney
Diverticulitis
Aortic Aneurysm
Pyelonephritis
Calculi
Acute Pain
Biliary Tract
Pelvis
Intravenous Injections
Pancreatitis
Abdomen
Infarction
Abdominal Pain
Dissection
Differential Diagnosis
Communication

Keywords

  • Abdomen, acute conditions, 72.25, 74.723, 751.291, 76.285, 762.81, 77.291, 81.2121, 82.21
  • Abdomen, CT, **.1211
  • Appendicitis, 751.291
  • Cholecystitis, 76.285
  • Computed tomography (CT), helical technology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Tailored helical CT evaluation of acute abdomen. / Urban, Bruce A.; Fishman, Elliot K.

In: Radiographics : a review publication of the Radiological Society of North America, Inc, Vol. 20, No. 3, 05.2000, p. 725-749.

Research output: Contribution to journalArticle

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