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).

DIVERTICULITS
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 CONTRAST
NO 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 PHASE
SCOUT: 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 + PELVIS
APPENDICITIS 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 SCAN
500 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