Download - Abdomen & Pelvis Pathology - CT-scan
ABDOMEN & PELVIS
PATHOLOGY & SCANNING PROTOCOLS
PATHOLOGIES
ABDOMINAL MESENTERIC CYST
ABDOMINAL CYST
An abdominal CT scan revealed a large right upper quadrant cyst measuring 14x17x21 cm ( lateral, anteroposterior and craniocaudal)There was mass effect upon the liver and duodenum. The cyst had a thin smooth wall with internal fluid and high density material consistent with a blood clot.
RENAL CYST
NO CONTRAST CONTRAST
POLYCYSTIC KIDNEY DISEASE
In PKD fluid-filled cysts develop giving the kidneys a honeycomb appearance. It is one of the most common inherited disorders, and the fourth commonest cause of kidney failure.
In polycystic kidney disease many fluid-filled cysts develop in the kidneys. Gradually these cysts replace the normal kidney tissue enlarging the kidneys but making them less and less able to function normally. Eventually the kidneys fail completely
HEPATOMEGALY
ASCITES
Ascites is the abnormal collection of fluid in the abdominal cavity, most often as a result of chronic liver disease.
SPLENOMEGALY
SPLENIC INFARCTION
APPENDICITS
An axial slice of a CT scan done with the use of intravenous and oral contrast is presented. The arrow points to an area of soft tissue induration within the retrocecal fat. There is a rim like area of higher attenuation within this area. The structure is fluid filled. These
features are compatible with a diagnosis of acute appendicitis and the presence of rupture cannot be excluded.
DIVERTICULITS
Diverticulitis is inflammation or infection of small pouches, called diverticula, that develop along the walls of your intestines. The formation of the pouches themselves is a relatively benign condition known as diverticulosis. The pouches can develop anywhere on the digestive tract, but they most commonly form at the end of the descending and sigmoid colons, and they also frequently occur on the first section of the small intestine (although they rarely cause problems there).
ABDOMINAL ABSCESS
Psoas abscess (blue arrow), and abscess dissecting anteriorly in transversalis fascia.
BOWEL OBSTRUCTION
LIVER METS
Lung cancer, small cell. Contrast-enhanced CT scan of the abdomen. Axial section through the liver shows multiple hypoattenuating areas in the liver. Poorly defined margins, attenuation greater than that of water, and scattered distribution in a patient with known lung cancer is most consistent with metastatic disease.
ESOPHAGEAL CANCER
WILMS TUMOR
Wilms tumor, also called nephroblastoma, is a cancer that originates in the kidney. The disease gets its name from a German doctor, Max Wilms, who wrote one of the first medical articles about it in 1899. Ninety percent of all kidney cancers in children are Wilms tumor. The remaining ten percent are rare forms of childhood kidney cancers: clear cell sarcoma of the kidney, malignant rhabdoid tumor of the kidney, and occasionally renal cell carcinoma
WILMS TUMOR
ADRENAL METS
RENAL STONE
HYDRONEPHROSIS
BLADDER CANCER
KIDNEY CANCER
Kidney cancer affects some 30,000 people in the United States each year, and close to 12,000 die from the disease. It is the eighth most common cancer in men and the tenth most common in women. Smoking is the major risk factor,
HORSESHOE KIDNEYS
PHEOCHROMOCYTOMA
Pheochromocytoma is a tumor of the adrenal gland that causes excess release of epinephrine and norepinephrine, hormones that regulate heart rate and blood pressure
CIRRHOSIS
HEMANGIOMA
A cavernous hepatic hemangioma is the most common non-cancerous tumor of the liver. It is believed to be a congenital defect, and is usually not discovered until medical pictures are taken of the liver for some other reason.
CHOLELITHIASIS
CHOLECYSTITIS
PANCREATIC CANCER
PANCREATITIS
ABDOMINAL ANEURYSM
PROTOCOLS
SPONGE
FEET FIRST OR HEAD FIRST
SCOUT: AP
LANDMARK: XIPHOID TIP
SCAN MODE: Spiral
I.V. CONTRAST: 1.5-2 ml/sec, 100-150 ML
SCAN DELAY: 75-80 sec
ORAL CONTRAST: 400 ml 45 MINUTES BEFORE SCAN, 200 ML JUST BEFORE SCAN
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 8-10 MM
START LOCATION: LUNG BASES
END LOCATION: ILIAC CREST
FILMING: STANDARD, LUNGS, LIVER + BONE FOR TRAUMA & CANCER
ABDOMEN STANDARD
ROUTINE
SCOUT: AP
LANDMARK: XIPHOID TIP
SCAN MODE: Spiral
NO ORAL CONTRASTNO IV CONTRAST
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 5MM
START LOCATION: ABOVE KIDNEYS
END LOCATION: S. PUBIS
FILMING: STANDARD
ABDOMEN-KIDNEY STONE
SCOUT: AP
LANDMARK: XIPHOID TIP
SCAN MODE: SPIRAL
I.V. CONTRAST: 4-5 ml/sec, 100-150 ML
SCAN DELAY: 1. NON-CONTRAST, 2. ARTERIAL 30 SEC. 3. PORTAL 70 SEC.
ORAL CONTRAST: 400 ml 45 MINUTES BEFORE SCAN, 200 ML JUST BEFORE SCAN
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 4-5 MM
START LOCATION: LUNG BASES
END LOCATION: ILIAC CREST
FILMING: STANDARD + LIVER
ABDOMEN LIVER MASS-3 PHASE
NON-CONTRAST ARTERIAL
PORTAL
LIVER SINGLE PHASESCOUT: AP
LANDMARK: XIPHOID TIP
SCAN MODE: Spiral
I.V. CONTRAST: 1.5-2 ml/sec, 100-150 ML
SCAN DELAY: 45 SEC
ORAL CONTRAST: 400 ml 45 MINUTES BEFORE SCAN, 200 ML JUST BEFORE SCAN
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 8-10 MM
START LOCATION: LUNG BASES
END LOCATION: ILIAC CREST
FILMING: STANDARD + LIVER + BONE FOR TRAUMA & CANCER
SCOUT: AP
LANDMARK: XIPHOID TIP
SCANNING MODE: SPIRAL
I.V. CONTRAST: 2-4 ml/sec, 100-150 ML
SCAN DELAY: 30-35 sec
ORAL CONTRAST: 400 ml 45 MINUTES BEFORE SCAN, 200 ml 15 MINUTES BEFORE SCAN
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 3-5 MM THROUGH PANCREAS
START LOCATION: LUNG BASES
END LOCATION: ILIAC CREST
FILMING: STANDARD + LIVER + BONE FOR TRAUMA & CANCER
ABDOMEN- PANCREAS
BETTER VISUALIZATION OF PANCREAS- R. LAT. DECUB.
SCOUT: AP
LANDMARK: XIPHOID TIP
SCANNING MODE: SPIRAL
I.V. CONTRAST: 2-4 ml/sec
SCAN DELAY:1. NONCONTRAST: 2. ARTERIAL 30 SEC. 3. NEPHROGRAM 90 SEC.:
4. PYELOGRAM 3-5 MIN.
ORAL CONTRAST: 400 ml 45 MINUTES BEFORE SCAN, 200 ml JUST BEFORE SCAN
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 8-10 MM , 5 MM THROUGH KIDNEYS
START LOCATION: LUNG BASES
END LOCATION: ILIAC CREST
FILMING: STANDARD
ABDOMEN- KIDNEYS
CTA OF THE ABDOMEN
SCOUT: AP
LANDMARK: XIPHOID TIP
SCAN MODE: Spiral
I.V. CONTRAST: 4-5 ml/sec, 100-150 ML
SCAN DELAY: 25 sec
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 3 MM
START LOCATION: ABOVE AORTIC ARCH
END LOCATION: BELOW ILIAC CREST
FILMING: STANDARD + 3D + MPR
ABDOMEN + PELVISAPPENDICITIS OR DIVERTICULITIS
SCOUT: AP
LANDMARK: XIPHOID TIP
SCAN MODE: Spiral
I.V. CONTRAST: 1.5-2 ml/sec, 100-150 ML
SCAN DELAY: 75-80 sec
ORAL CONTRAST: 400 ml 45 MINUTES BEFORE SCAN, 200 ML JUST BEFORE SCAN
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 8-10 MM UPPER + 5 MM LOWER
START LOCATION: LUNG BASES
END LOCATION: S. PUBIS
FILMING: STANDARD
8 MM
SCOUT: AP
LANDMARK: XIPHOID TIP
SCAN MODE: Spiral
I.V. CONTRAST: 1.5-2 ml/sec, 100-150 ML
SCAN DELAY: 75-80 sec
ORAL CONTRAST: 500 cc 60-120 MINUTES BEFORE SCAN, 200 ML JUST BEFORE SCAN
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 8 MM + 3-5MM LOWER
START LOCATION: LUNG BASES
END LOCATION: S.PUBIS
FILMING: STANDARD
5 MM
CTA ABDOMEN
CT COLONOSCOPY
2 SCANS- PRONE + SUPINE
SCOUT: AP
LANDMARK: ILIAC CREST
SLICE PLANE: AXIAL OR SPIRAL
I.V. CONTRAST: 1.5-2 ml/sec, 100-120 ml
SCAN DELAY: 120-180 sec (FULL BLADDER)
ORAL CONTRAST: 300-500 ml 1-2 HOURS BEFORE SCAN500 cc NIGHT BEFORE
BREATH HOLD: SUSPENDED EXPIRATION
SLICE THICKNESS: 8-10 MM, 3-5 MM IF AP OR DIVERTICULITIS
START LOCATION: ILIAC CREST
END LOCATION: SYMPHYSIS PUBIS
FILMING: STANDARD
PELVIS
DETECTION OF PROSTATE GLAND AND SEMINAL
VESICLES ABNORMALITIES
BLADDER OPACIFIED
+RECTOSIGMOID COLON AND RECTUM OPACIFIED
VISUALIZATION OF VAGINAL CANAL + CERVIX
AND UTERUS
TAMPON INSERTED IN THE VAGINA DURING CT SCAN OF THE PELVIS