Multidetector computed tomography of acute abdomen

Abstract

Acute abdominal pain is one of the most common causes for referrals to the emergency department. The sudden onset of severe abdominal pain characterising the "acute abdomen" requires rapid and accurate identification of a potentially lifethreatening abdominal pathology to provide a timely referral to the appropriate physician. While the physical examination and laboratory investigations are often non-specific, computed tomography (CT) has evolved as the first-line imaging modality in patients with an acute abdomen. Because the new multi-detector CT (MDCT) scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of CT for abdominal imaging has increased rapidly. The goal of this article is to discuss the role of MDCT in the diagnostic work-up of acute abdominal pain.

Perforated Meckel’s Diverticulum in an Adult

“…However, these methods have been progressively replaced by CT scan, which is now routinely used as the first-line imaging tool in the diagnostic workup of the acute abdomen [20]. The sensitivity of diagnosing the MD on CT scan has increased owing to the availability of higher spatial resolution and multiplanar isotropic reconstruction ability of the latest MDCT scanners, which allow visualization of the small bowel in various planes [21].…”

Early laparoscopy for the evaluation of nonspecific abdominal pain: a critical appraisal of the evidence

“…The acceptance of abdominal CT scans for abdominal imaging in patients with NSAP has increased rapidly. With the use of new multidetector CT (MDCT) scanners with higher speed, greater coverage, and thinner slices, it is possible to achieve an accurate diagnosis in over 98% of cases [16], making this technology the first-line imaging modality in patients with an acute abdomen [18,19]. Common disadvantages of the CT scan are related to its lack of availability in most emergency services, cost, and the use of variable doses of radiation [18,19].…”

Acute Abdomen: Rational Use of us, MDCT, and MRI

“…MIPs are obtained by the projection onto an image plane of the highest-attenuation voxels encountered through a volume, which allows structures not lying in a single plane to be evaluated. Thus, MIP has found many applications in CT angiography and CT urography (Leschka et al 2005). The reconstruction of VR images is particularly helpful for visualizing the complex anatomy and pathologies of the visceral vasculature and better delineates a tortuous course of vessels and small branches than MPR or axial images alone (Leschka et al 2005).…”

“…MDCT examination at reduced exposure factors maintains the diagnostic accuracy. Unenhanced, low-dose MDCT provides a rapid and accurate diagnosis of ureteral stones, because almost all calculi are radio-opaque at CT (Leschka et al 2005). Obstructing ureteral calculi are typically located at the ureteropelvic or ureterovesical junction.…”

“…Secondary CT signs of urolithiasis include hydro-ureter, hydronephrosis, peri-nephric stranding, and renal enlargement. The use of oblique-coronal reconstructions is more effective for precise stone localization and measurement than axial slices (Leschka et al 2005). With MDCT, high-resolution, cine-viewing reconstructions can be obtained from thin-collimation acquisitions.…”