The full report is titled diagnostic performance of multidetector computed tomography for suspected acute appendicitis. In complex fractures, however, computed tomography ct is an imaging modality often used after radiography. A variety of techniques and options are available when evaluating for arterial injuries. Request pdf multidetector computed tomography in abdominal emergencies. Noncontrast multidetector computed tomography in the evaluation of acute abdomen. Multi detector computed tomography mdct evaluation of.
Techniques involve contrast bolus, various phases of contrast enhancement, multiplanar reconstruction, volume rendering, and. It is also a useful test to investigate acute abdominal pain especially of the lower quadrants, whereas ultrasound is the preferred first line investigation for. To retrospectively determine the value of the nonvisualized appendix at multidetector computed tomography ct in patients with acute right lower quadrant pain in whom appendicitis was a consideration. Conventional radiography plays an essential diagnostic role in the primary evaluation of acute joint trauma. Mdct is useful in making a prompt, more precise diagnosis of mesenteric ischaemia, as well as identifying the cause and potential complications, which are key to reducing patient morbidity and mortality. The role of mdct in the evaluation of patients with acute. Objectives to investigate opacification of the thoracic aorta and taa using a caudocranial scan direction and a patientspecific contrast protocol. Leschka s, alkadhi h, wildermuth s et al 2005 multidetector computed tomography of acute abdomen. Ct is considered the imaging technique of choice in the diagnostic workup of both localized and diffuse acute abdomen, except in patients in whom acute cholecystitis or acute gynecological disease is suspected and in children, adolescents, and pregnant patients, in whom ultrasonography is the imaging technique of. To explore the sensitivity and specificity of mdct in acute abdomen cases with intraoperative surgical. Surgical intervention is indicated in acute intestinal obstruction due to organic pathology, closed loop obstruction, complications like strangulation or perforation. A number of terminologies are in use for this technology, namely multi detector row computed tomography mdct, multi detector ct mdct, multi detector array helical ct, multi channel ct and multi slice ct msct. Multi detector computed tomography mdct is the most commonly utilized radiologic investigation in such patients as it can be performed fairly rapidly and has excellent accuracy for diagnosing.
Despite dedicated protocols and technical advances, mdct of uncommon causes of acute abdominal pain still represents a significant challenge for the radiologist on. Computed tomography ct has proved to be invaluable, noninvasive, technique for detailed assessment of pancreas during its acute inflammatory stage. Imaging patients with acute abdominal pain rsna publications. In complex fractures, however, computed tomography. Acute pulmonary embolism in the era of multidetector ct. Multidetector computed tomography hatem alkadhi of acute abdomen. Cme article incidental cardiac abnormalities on non. Multidetector computed tomography mdct plays an important role in revealing the site, level, and cause of obstruction and demonstrating threatening signs of bowel inviability. In a, a cluster of fluidfilled dilated small bowel loops can be appreciated in the left flank along with the evidence of mesenteric fluid arrow. Breathhold threedimensional ct of the liver with multi detector row helical ct.
Although an increasing number of pathognomonic ct findings of internal hernia have been reported, the majority of such reports are individual case reports. It is in the 21 june 2011 issue of annals of internal medicine volume 154, pages 789796. Acute abdomen is a common presentation in the emergency department and radiologic imaging plays a pivotal role in the evaluation of such patients. Emergency laparoscopic bowel reduction was performed. Computed tomography is universally considered the key imaging modality for the evaluation of severe trauma patients and patients with nontraumatic acute abdominal disease. Multidetector row computed tomography findings from.
Ct is frequently performed, with stone detection sensitivity of 95%. Mdct evaluation of nontraumatic acute abdomen eprints. Approximately 5% of patients with pmc present with symptoms and signs of acute abdomen or abdominal sepsis. Ct was performed within the first 48 h from patient admission using 64 slicerotation ct machines philips health care nederland b. Canine patients with acute abdominal signs are often clinically unstable and need a rapid and accurate diagnosis. Multi detector computed tomography mdct evaluation of small. Multidetector computed tomography of acute abdomen request pdf.
Multidetector computed tomography mdct angiography is the preferred imaging test for acute and chronic mesenteric ischaemia. Crosssectional imaging has become a critical aspect in the evaluation of arterial injuries. Multi detector computed tomography mdct is the most commonly utilized radiologic investigation in such patients as it can be performed fairly rapidly and has excellent accuracy for diagnosing various causes of an acute abdomen. Thanks to the new dedicated reconstruction program, its diagnostic potential is much improved compared to the past and currently it is superior to that of any other noninvasive technique. Pdf role of mdct 128 slice scanner in acute abdomen. Because the new multidetector ct mdct scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of ct for. Pdf acute lower gastrointestinal bleeding from the. Evaluation of suspected renal colic patients with unenhanced. Acute abdominal pain is a common condition accounting for 45% of all emergency department admissions, 1 involving a sudden onset of severe pain developing over hours associated with abdominal tenderness and rigidity. Materials and methods thoracic aortic cta was performed in 160 consecutive patients with suspected taa using a 256slice computed tomography scanner and a dual barrel contrast injector. To evaluate the accuracy and impact of early ct in the diagnosis of non traumatic acute abdomen when usg or xray findings are negative, equivocal or unable to provide additional information regarding the diagnosis. Acute abdominal pain is a common symptom for seeking urgent medical evaluation.
Patients are triaged by the emergency department nurse as level 2. It is used frequently to determine stage of cancer and to follow progress. In some patients with acute abdominal pain, the coronal plane images may serve as a useful adjunct to. Colonic perforation by a transmural and transvalvular. Multidetector computed tomography of acute abdomen, european. Ct has been proven to be highly sensitive and specific for numerous gastrointestinal, urologic and other conditions 1. Multidetector computed tomography in the evaluation of pediatric. Doctors often use computed tomography ct or cat scans, which allow them to view the inside of the abdomen and pelvis in a quick, noninvasive manner.
Optimization of eightelement multidetector row helical ct. Because the new multi detector ct mdct scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of ct for. Multidetector computed tomography ct has emerged as the modality of choice for evaluation of patients with several acute traumatic and nontraumatic conditions causing right lower quadrant pain. Mdct a form of computed tomography ct technology for diagnostic imaging. Computed tomography angiography in patients with active. The introduction of singledetector helical computed tomography sdct in 1989 was the first step in a transition from viewing ct as a series of sequential axial sections to perceiving each examination as a volumetric acquisition of anatomic data.
Newer, multidetector ct provides clearer images than older ct technology. The costeffectiveness of ct in the setting of acute appendicitis was. Rees, mbchb edin, frcr, frcp c, professor of radiology. Now electrocardiogram ecggating technology is widely available, ecggated multi detector row computed tomography mdct is a powerful clinical tool in the acute emergency setting, which enables rapid and specific diagnosis of aortic pathology. May 01, 2000 multi detector computed tomography of acute abdomen 27 august 2005 european radiology, vol. Multidetector computed tomography ct has established its status as a powerful diagnostic tool for acute abdomen, and this remains true for internal hernias. Physics properties of nonhelical scan using 320row multi detector computed tomography japanese journal of radiological technology, vol. Unenhanced a and contrastenhanced b axial images of the abdomen are shown. The role of multi detector computed tomography in diagnosis. C 14 computed tomography is the imaging study of choice for evaluating. Multidetector computed tomography of acute abdomen abstract acute abdominal pain is one of the most common causes for referrals to the emergency department. Noncontrast multidetector computed tomography in the. Computed tomography of the abdomen and pelvis is an application of computed tomography ct and is a sensitive method for diagnosis of abdominal diseases.
Multidetector computed tomography of mesenteric ischaemia. The number of simultaneous but independent measurements along the patient long axis is often referred to as the number of. Technical innovations in multidetector computed tomography mdct have accelerated this transition. Intestinal obstruction is responsible for approximately 20% of surgical admissions for acute abdominal conditions. The aim of this study was to assess the incidence of pe in patients with clinical suspicion of acute pe using mdct in a subsaharan setting, and to describe the demographic. Appendicitis is the most common cause of acute abdomen and the most common acute condition requiring surgery. Multidetector computed tomography in the evaluation of pediatric acute abdominal pain in the emergency department weiching lin and chienheng lin department of radiology, china medical university hospital, 404 taichung, taiwan. The typical radiological appearances of these conditions on multidetector computed tomography are illustrated. In phase one of this study we hypothesized that cemdct would be a feasible and safe technique for use in awake and lightly sedated dogs with acute abdominal. Due to technical breakthroughs in the field, multidetector computed tomography mdct allows faster imaging and better temporal, spatial, and contrast resolution compared with conventional singleslice spiral ct. Evaluation of acute abdominal pain in adults sarah l. Because the new multidetector ct mdct scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of ct for abdominal imaging has increased rapidly. Multidetector computed tomography hatem alkadhi of acute.
Computed tomography of the abdomen and pelvis wikipedia. An axial image from a computed tomography aortogram at the upper abdominal aorta shows the beak sign arrow. Managing patient dose in multidetector computed tomography. We sought to assess retrospectively the added value of coronal reformations from isotropic voxels obtained with 64slice multidetector row computed tomography ct of the acute abdomen. To explore the sensitivity and specificity of mdct in acute abdomen cases with intraoperative surgical finding histopathological findings clinical findings as reference standards. Several signs have been described including swirled mesenteric. The coverage goes far beyond just a howto or an encyclopedia of findings, however. In severe cases, colitis may progress to toxic megacolon and colonic perforation due to fullthickness colonic necrosis. Detailed evaluation, proper staging on scoring basis and prediction of morbidity and mortality are possible with the help of advanced highresolution multi detector multislice ct. Breathhold threedimensional ct of the liver with multidetector row helical ct.
Multi detector computed tomography in the diagnosis of bowel injury sarita magu, shalini agarwal, and ravinder singh gill department of radiodiagnosis, pandit bhagwat dayal sharma, post graduate institute of medical sciences, rohtak, 124001 haryana india. Multi detector computed tomography mdct represents the gold standard in patients with acute abdomen syndrome and suspected bowel ischemia. Multidetector computed tomography mdct imaging of the abdomen and pelvis is the imaging examination of choice for evaluating patients presenting with abdominal pain. The primary imaging modality is plain abdominal radiography, however it has a sensitivity of 48% to 80%. During the last years, a trend towards increased use of computed tomography in patients with acute abdomen can be seen. Multidetector computerized tomography in acute abdomen rafiq. Multidetector computed tomography in the evaluation of.
According to the 010 point pain numeric rating scale nrs11, 2 severe pain is described as 8 or higher. Helical computed tomography ct allows rapid, costeffective evaluation of patients with acute abdominal pain. Although electrocardiogram ecggated multi detector ct mdct images provide superior imaging of various cardiac diseases, nonecggated mdct images of the thorax and abdomen usually provide. Helical computed tomography in evaluation of selected cases. Multidetector computed tomography of acute abdomen core reader. Mdct is performed as first imaging examination for patients with acute abdomen in most emergency departments. Multi detector computed tomography is the most accurate imaging technique that must be promptly performed in all patients with bowel ischemia. Contrastenhanced multi detector computed tomography cemdct is the current modality of choice for evaluating acute abdominal pain in people. Aug 27, 2005 read multi detector computed tomography of acute abdomen, european radiology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Clinical suspicion of ischemic colitis and infarction is related to specific findings, however, differential diagnosis as well as the staging for a confirmed ischemic affection may be critical.
Abdomen, pelvis, and cad applications contains easily searchable clinical specialty chapters that provide specific information without need of an index. To retrospectively evaluate the accuracy of multidetector computed tomography ct in the diagnosis of perforated acute appendicitis by using surgery and pathologic examination combined as the reference standard. Oct 17, 2012 the advantages of multi detector computed tomography mdct have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism pe is an exponent. Use of multidetector computed tomography for locating the. Acute lower gastrointestinal bleeding from the appendix diagnosed by abdominal multidetector computed tomography. Multislice computed tomography examination of the abdomen and pelvis, non contrast and enhanced series arterial and venous phases. Multidetector computed tomography of acute abdomen 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. In case of acute abdomen unenhanced ct scan is not performed routinely. Detection and localization of active gastrointestinal bleeding with multidetector row computed tomography angiography.
Is oral contrast necessary for multidetector computed. In a, a cluster of fluidfilled dilated small bowel loops can be appreciated in the left flank along with the evidence of mesenteric fluid. Figure 1 contrast enhanced multi detector computed tomography cemdct shows lacerations of the right lobe of the liver vi segment black arrow, devascularization of the right kidney black arrowhead, and hematoma of the right adrenal gland white arrow. Mdct is used routinely in evaluating human patients with acute abdominal symptoms. Perforated versus nonperforated acute appendicitis. Contrastenhanced multidetector computed tomography cemdct is the current modality of choice for evaluating acute abdominal pain in people. A total of 98 patients with pneumoperitoneum on mdct were retrospectively analyzed.
As a result, ct is increasingly used in the emergency department setting. Aug 27, 2005 while the physical examination and laboratory investigations are often nonspecific, computed tomography ct has evolved as the firstline imaging modality in patients with an acute abdomen. Jcm free fulltext multidetector computed tomography. Multidetector ct mdct is an imaging technique that provides otherwise. We report the case of a 52yearold female with a past surgical history and recurrent episodes of abdominal pain. Iatrogenic vascular causes of acute abdominal pain are important.
Mdct has become a fundamental tool for determining the causes of acute abdomen. Abdominal emergencies encompass traumatic events in the region of the abdomen as well as the clinical term acute abdomen. 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. Multidetector computed tomography of the acute abdomen in. Multidetector computed tomography in the diagnosis and management of acute aortic syndromes. Multidetector computed tomography of acute abdomen core. A a subtle perihepatic fluid collection is seen white arrowhead. Multiplanar computed tomography of vascular etiologies of acute.
Multidetector computed tomography mdct is the most commonly. Optimized multidetector computed tomographic protocol for the diagnosis of active obscure gastrointestinal bleeding. A mural hematoma can also be appreciated arrowheads. While the physical examination and laboratory investigations are often nonspecific, computed tomography ct has evolved as the firstline imaging modality in patients with an acute abdomen. Multidetector ct is an extremely useful noninvasive method for diagnosis and management of not only the most common causes such as appendicitis but. Comparison between survey radiography, bmode ultrasonography, contrastenhanced multi detector computed tomography findings in dogs with acute abdominal signs. Multidetector computed tomography of acute vascular injury.
The purpose of this study was to analyze the multidetector computed tomography mdct morphologic characteristics of nonaortic acute vascular injuries avi in patients with blunt abdominopelvic trauma that predict treatment. Ct exams had been performed in all cases using a 64 multi detector ct machine. Multidetector computed tomography in the diagnosis and. Imaging patients with acute abdominal pain radiology. Multidetector computed tomography in the evaluation of pediatric acute abdominal pain in the emergency department. To evaluate the accuracy of mdct 128 slices in the diagnosis of acute abdomen 2. Transmural migrated retained sponges usually impact at the level of the ileocecal valve leading to a small bowel obstruction.
Request pdf multidetector computed tomography of acute abdomen 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. Multidetector computed tomography in acute abdomen. The purpose of this study was to evaluate the accuracy of multidetector computed tomography mdct for locating the site of gastrointestinal tract perforations and to determine the most predictive signs in this diagnosis. Multidetector computed tomography mdct has established indications and time frames for staging severity of pancreatitis in the acute phase. Rapid preoperative diagnosis of ileal hernia through the. Multidetector ct features of acute intestinal ischemia and. Multidetector computed tomography in acute joint fractures.
To assess the efficacy of mdct in differentiating the various pathological causes of acute abdomen. In particular, angiography using computed tomography ct is the imaging of choice. Unenhanced helical ct compared with threeview acute abdominal series1. The clinical manifestations vary according to the nature of presentation acute or subacute, complete or partial and simple or complicated. Tailored helical ct evaluation of acute abdomen radiographics. Additionally, patient with severe claustrophobic often cannot tolerate mr scanner. A ct scan or computed tomography scan formerly computerized axial tomography scan or cat scan makes use of computerprocessed combinations of many xray measurements taken from different angles to produce crosssectional tomographic images virtual slices of specific areas of a scanned object, allowing the user to see inside the object without cutting. Part of a twovolume set that covers all aspects of ct imaging, multidetector ct imaging. Multidetector computerized tomography in acute abdomen. Cureus multiplanar computed tomography of vascular.
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