All patients subsequently underwent laparoscopy by a surgeon who was blind to the diagnosis suggested. A supine abdominal radiograph is obtained and appears to be normal. The divisions areas of expertise include abdominal and pelvic ct scanning we have an active ct colonography program, abdominal mri and advanced ultrasound techniques. Christian fox, md, rdms, associate professor of emergency medicine, university of californiairvine school of medicine, irvine, ca. In many eds the initial interpretation of images are performed by emergency physicians ep. The below ct axial slices highlight common anatomical structures which are helpful to know when interpreting a ct brain scan. Ct acute medical and surgical interpretation lightbox.
Most of the ct pictures are non specific ct pictures are depending on the density of the structures. For example, it is commonly reported that a ct scan may be associated with an increase in the risk of cancer of approximately 1 in 2,000. The following are the different types of computed tomography ct scans. Computed tomography ct scan, also known as computerized axial tomography, or ct scanning computerized tomography is a painless, noninvasive diagnostic imaging procedure that produces crosssectional images of several types of tissue not clearly seen on a traditional xray ct scans may be performed with or without contrast medium. Ct of the abdomen and pelvis is the first line imaging modality for staging, selecting treatment options and assessing disease response in ovarian cancer. Depending on the circumstances, we may decide to perform the study without iv contrast administration to rule out potentially lifethreatening conditions, such as pneumoperitoneum, bowel obstruction, appendicitis, aortic aneurysm, and so on 1, 2. The staging ct provides disease distribution, disease burden and is the imaging surrogate for surgicopathological figo staging. Radiology residents are often faced with requests for urgent ct of the abdomen in patients with renal impairment or renal failure who present with acute abdominal symptoms.
An abdominal ct scan helps your doctor see the organs, blood vessels, and bones in your abdominal cavity. Ct scans interpretation principles basics teachmeanatomy. Can a clinician interpret ct scan like a radiologist. Duplex collecting system on the right side, which is an anatomical variant. Use of specific xray machine for capture images of inside of abdomen is the feature of abdominal ct scan. Prepare for abdominal ct scan american health imaging. Although this is a seemingly daunting task for the software developer, the numbers of organs and potential abnormalities are finite and can be. The panscan computed tomographic ct examination of the head, neck, chest, abdomen, and pelvis has become an essential element in the early evaluation and decisionmaking algorithm for hemodynamically stable patients who sustained abdominal trauma. Book on diagnostic impact of ct scans in severe abdominal trauma and nontraumatic acute abdomen. A prospective study was undertaken to assess the interobserver variability in ct scan interpretation in patients with suspected acute appendicitis.
Radiation dose associated with common computed tomography. An understanding of the quadrant anatomy allows you to identify relevant pathology. A ct abdomen in its simplest form is a ct from diaphragm to symphysis pubis performed 60 seconds after pumpinjection of iodinated contrast into a peripheral vein. The abdomen can be divided into four quadrants, each containing specific visceral organs. Abdominal ct scans use xray technology to take pictures of your abdomen, giving your doctor more information so he or she can make a diagnosis. Sep 28, 2015 head ct interpretation made easy daniel mccollum. Endorsed by world society of emergency surgery wses and american academy of surgery for trauma aast. When interpreting at ct scan, it is important to determine the orientation.
Scan performed supine during the portal venous phase. Mayo clinic is committed to taking care of our patients, learners and staff as we address the covid19 situation. Triphasic scan for liver arterial, portal, delayed. Ct scan in abdominal emergency surgery fausto catena springer. Ct scanning is fast, painless, noninvasive and accurate. Computed tomography also known as ct scan or cat scan is a diagnostic test in which images of the body are generated with the help of a computer. A computerized tomography ct scan combines a series of xray images taken from different angles around your body and uses computer processing to create crosssectional images slices of the bones, blood vessels and soft tissues inside your body. The corresponding lifetime attributable risks of cancer were also higher than typically reported and markedly variable by study type, patient, and hospital. Dec 23, 2007 for urinary stones, ct has a sensitivity of 96100% and specificity of 9499%, 30 and for acute pyelonephritis although usually diagnosed based on clinical symptoms, it can be confused with other disease processes and occasionally requires imaging, ct is much more sensitive than ivp. A systematic approach to the evaluation and management of various complaints. Multidetector ct of blunt abdominal trauma radiology.
Progress in fully automated abdominal ct interpretation. Principles of ct diagnosis precontrast study postcontrast study change in adjacent structures. Abdominal organs can also be categorized as to whether are retroperitoneal. A computed tomography ct scan can create crosssectional images of any part of your body using special xrays and a computer.
If your doctor has ordered an abdominal ct scan, you probably have questions about the procedure and how you should prepare for it. Pearls and pitfalls in interpretation of abdominal and pelvic. Aug 14, 20 many patients are brought to crowded emergency departments ed of hospitals every day for evaluation of head injuries, headaches, neurologic deficits etc. Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. Jan 31, 2020 a computed tomography ct scan can create crosssectional images of any part of your body using special xrays and a computer. Improper technique, observers errors, and lack of clinical. Pearls and pitfalls in interpretation of abdominal and. How the test is performed you will lie on a narrow table that slides into the center of.
Equipment includes mri, ct, digital fluoroscopy, pet and and numerous ultrasound units. S6473 february 2004 with 1,966 reads how we measure reads. Abdominal computed tomography ct scanning has revolutionized patient care in the past two decades. Basic interpretation of ct scans most of the ct pictures are nonspecific ct pictures are depending on the density of the structures.
Abdominal ct scan interpretation answers on healthtap. Ct scan of the head is the most common diagnostic measure used to search for pathologies. The patients body is exposed to xrays and a computer is used to provide crosssectional images or slices of the body. Ct abdomen pelvis interpretation cystic lesion in the inferior right lobe of the liver most consistent with hepatic abscess.
To perform fully automated abdominal ct image interpretation at the level of a trained radiologist, the computer must assess all the organs and detect all the abnormalities present in the images. Nov 23, 2015 you cant always wait for the report, so you need to know how to interpret an abdominal ct without one. A head ct at the level of the suprasellar cistern demonstrating the midbrain m, fourth ventricle and cerebellar vermis v. Many factors result in suboptimal performance of abdominal computed tomography ct or inaccurate interpretation of the images. Abdominal ct scan crossing the barrier in bedside interpretation 2. A ct computed tomography scan, also called a cat scan, is a type of specialized xray. Ct abdomen is an increasingly common investigation that is used to help make diagnoses of a broad range of pathologies. The introduction of ct technology is widely viewed by medical practitioners as one of the major medical advances. Abcs of head ct interpretation in the emergency department.
An abdominal ct scan is an imaging method that uses xrays to create cross sectional pictures of the belly area. How to read an abdominal computed tomography scan 200801. This photo gallery presents the anatomy of the abdomen by means of ct axial, coronal, and sagittal reconstructions. Physicians interpreting petct scans should be familiar with the artifacts associated with the modalities, both individually and in combinationas well as with the principles of petctto ensure accurate scan interpretation and optimal patient care. Precontrast study postcontrast study change in adjacent structures clinical information biological or anatomical characteristics.
Viewing a ct scan, an experienced radiologist can diagnose many causes of abdominal pain with. This article will cover some of the underlying principles of ct head studies, and discuss a method for their interpretation. Computed tomography ct scanning involves the use of xrays to take crosssectional images. A systematic approach to the interpretation of ct abdomen.
Learn why a ct scan is performed and what to expect during a ct scan. Westin, md candidate 2008, university of californiairvine school of medicine, irvine, ca. Images are most commonly presented in the transverse plane, and are orientated so that we are looking up the body from the patients toes. In this article, we will outline the basic science behind ct scans, describe the principles of interpretation, and highlight their advantages and. All patients subsequently underwent laparoscopy by a surgeon who was blind to the diagnosis suggested by. 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. With a ct scan, the machine circles the body and sends the images to a computer, where theyre viewed by a technician. Computed tomography, more commonly known as a ct or cat scan, is a diagnostic medical imaging test.
A ct scan is a series of crosssectional xray images of the body. Streak artifact is also present in the posterior fossa. Abdominal ct scanning is used in the evaluation of trauma victims for visceral injury and in the evaluation of acute abdominal pain, with a major role in the evaluation of. It provides detailed images of abdominal organs such as liver, pancreas, spleen, kidneys, gastrointestinal tract, colon and rectum. Abdominal ct scan is an excellent way to visualize the contents of abdomen. The ct will show spasm or edema swelling of the bowel wall but you need something such as endoscopic studies to rule out any inflammatory disease which is a serious health issue, unlike that of irritable bowel which is also painful but. Computed tomography ct scan or cat scan is a noninvasive diagnostic imaging procedure that uses a combination of xrays and computer technology to produce horizontal, or axial, images often called slices of the body. What is the most appropriate next imaging examination. Abdomen and pelvis ct anatomy mamdouh mahfouz md mamdouh. A helpful way to get your bearings is the acronym ralp. Computed tomography ct scanning is an extremely common imaging modality in modern medicine. The morbidity, mortality, and economic costs resulting from trauma in general, and blunt abdominal trauma in particular, are substantial.
You can learn to read a ct scan if you understand the normal. With advancements in technology, it is rapidly replacing many diagnostic radiographic procedures. For thiqa members, ct of the abdomenpelvis should only be requested by a. Interpretation of abdominal ct scan mayo clinic school. Interobserver variability in ct scan interpretation for. The perfect introduction to computed tomography in the acute clinical setting. Abdominal ct scans are generally evaluated in the transversal direction. Samuel madoff, md, department of imaging sciences, university of. Ct scan of the abdomen orand pelvis is covered for all health insurance plans administered by daman, as per policy terms and conditions. A mri scan b followup ct scan in 3 months c lymph node biopsy key d clinical followup case 3 a 73yearold man presents to the emergency department with abdominal pain and nausea 1 day after a colonoscopy. Computed tomography ct abdomen and pelvis computed tomography ct of the abdomen and pelvis is a diagnostic imaging test used to help detect diseases of the small bowel, colon and other internal organs and is often used to determine the cause of unexplained pain. Follow the abdominal aorta down including its branches celiac, sma, paired renal arteries, ima aortic bifurcation. Multiphase abdominal ct online radiology course lecturio.
Dec 05, 2017 a systematic approach to the interpretation of ct computed tomography of the abdomen and pelvis. Endorsed by world society of emergency surgery wses. Computed tomography ct scan nursing responsibilities. A systematic approach to the interpretation of ct abdomenpelvis. Learn more about covid19 online education, resources, and live course cancellations through june 30, 2020. Pete thurley tells jon lund the secrets of radiology and provides a structure to work. Optimal cytoreductive surgery offers patients the best chance for disease control or cure, but suboptimal. A systematic approach to the interpretation of ct computed tomography of the abdomen and pelvis.
Depending on the circumstances, we may decide to perform the study without iv contrast administration to rule out potentially lifethreatening conditions, such as. The scan can show crosssectional images of a specific area of the body. Please see the xrayct technique class for additional information about the technique of computer tomography ct. How to read an abdominal computed tomography scan 2008. A normal head ct scan at the level of the atria of the lateral ventricles figure 8. Like traditional xrays, it produces multiple images or pictures of the inside of the body. Ct scan of the abdomen and pelvis combines radiologic and computer technology to determine the cause of unexplainable abdominal or pelvic pain and diseases of the bladder, uterus, liver, colon, small bowel, and other internal organs. Ct scans allow doctors to see crosssectional ct scan images slices of your body. For medical professionals ct scan is not covered for screening purposes for any plans. In the evaluation of abdominal and pelvic ct scans, no significant differences were observed in comparing softcopy and hardcopy interpretation. However, depending on the clinical question, a variety of. You cant always wait for the report, so you need to know how to interpret an abdominal ct without one.
The multiple images provided give your doctor many different views of your body. Triphasic scan for liver arterial, portal, delayed detailed examination of the superior mesenteric artery and celiac artery. A ct scan shows detailed images of any part of the body, including the bones, muscles, fat, organs, and blood vessels. Pdf abcs of head ct interpretation in the emergency. In this article, we will outline the basic science behind ct scans, describe the principles of interpretation, and highlight their advantages and drawbacks compared to other imaging techniques. This type of radiology study is an important part of diagnosing medical diseases like strokes, cancers, and infections in the abdomen like appendicitis.
The following images are representative axial slices through the normal brain proceeding inferiorly from the most superior axial slice figures 5 8. The ct scanning is usually completed within 30 minutes. Normal ct of the abdomen with oral and intravenous contrast. Introduction ct anatomy abdomen ct section with pathology take home message 6. The crosssectional images generated during a ct scan can be reformatted in multiple planes. Computed tomography ct or cat scan of the abdomen johns. Ct scan in abdominal emergency surgery fausto catena.