CT SCAN ABDOMEN

Hosiana Oktaviany Winaris

42180258
dr. Sudharmaji Sp.Rad , MPH
DEFINITION
• CT abdomen is an increasingly common
investigation that is used to help make
diagnoses of a broad range of pathologies.

• A CT abdomen in its simplest form is a CT

from diaphragm to symphysis pubis performed
60 seconds after pump-injection of iodinated
contrast into a peripheral vein.
INDICATION

• abdominal pain
• abdominal sepsis
• bowel obstruction
• post-operative complications
• trauma
• vascular compromise, e.g. aortic
aneurysm
IMPORTANT PATHOLOGY
• bowel obstruction
• bowel perforation
• colon cancer
• intra-abdominal trauma
BENEFITS

• relatively quick and accessible

• reproducible findings
• complete assessment of the
abdomen and pelvis
LIMITATION

– uses ionizing radiation
• risk of radiation-induced cancer
• approximately 100 times the dose of a chest
radiograph
– requires iodinated IV contrast
• risk of deterioration in renal function
• risk of anaphylactic reaction
PROCEDURE

• check renal function

• lie patient supine on CT table
• scout image to plan study
• IV contrast injected via pump-
injector
• 60-second delay
• scan from dome of diaphragms to
symphysis pubis
Portal venous phase: the parenchyma of the liver/spleen/pancreas is homogeneously enhanced.
Intra-abdominal fat has the density of fat (HU -50 to -100; see the X-ray/CT technique course for
more information about Hounsfield units); similar to normal subcutaneous fat. If not, there may be
ascites or fatty infiltration.
LIVER

A normal liver enhances homogeneously (irrespective of the scan phase).

The liver receives about 80% of its blood through the portal vein (=
nutrient-rich blood from the intestines). The remaining 20% is supplied by the
hepatic artery. 
If focal liver pathology is present, it is important to document its location. This
may be crucial to any surgical options. Using the Couinaud classification, the
liver is subdivided into eight individually functioning segments. Each segment
has its own afferent hepatic artery and portal vein, and efferent hepatic vein
and efferent bile ducts
Liver cirrhosis is the result of chronic liver disease, causing irreversible
damage to the liver tissue. The liver is small and proportions have
changed; the left liver lobe and segment 1 are hypertrophic, and the
right liver lobe is atrophic. The liver tissue and surface has a nodular
aspect (fig. 7). Liver cirrhosis may increase the pressure in the hepatic
vessels, giving rise to ‘portal hypertension’. Signs of portal
hypertension include collateral formation, splenomegaly and ascites. 
Gallbladder and bile ducts

Normal undilated intrahepatic bile ducts are invisible on an

abdominal CT.
The left and right hepatic duct join to form the common
hepatic duct. These in turn join the cystic duct to form the
choledochous duct.
The choledochous duct eventually joins the pancreatic duct at
the level of Vater's papilla, where the bile and pancreatic juice
is released into the duodenum
Pancreas

The pancreatic drainage system is variable. Many people have one

pancreatic duct which drains into Vater's papilla. Some people have an
accessory pancreatic duct, also known as Santorini’s duct (anatomic
variation). The accessory pancreatic duct drains into the minor papilla 
Spleen

Because of its specific vascularization, the spleen enhances

inhomogeneously/with stripes in the arterial phase; this is a
normal finding. However, the spleen should enhance
homogeneously in the portal venous phase
REN

An abdominal CT without contrast agent is performed to detect kidney,

ureter and bladder stones. Stones are hyperdense and may form at
any location in the urinary tract. Depending on their size, ureteral
stones may cause obstruction. Signs of obstruction include dilation of
the collecting system of the kidney (‘hydronephrosis’) and the ureter
proximal of the obstruction
LYMPH NODES

Lymph nodes are spread out over the entire abdominal cavity.
Normal lymph nodes have an oval shape and a short-axis diameter
of less than 10 mm. Normal lymph nodes also have a fat center.
The term lymphadenopathy is used when the lymph nodes have a
short-axis diameter exceeding 10 mm
ILEUS

Ileus refers to reduced intestinal passage, with fecal accumulation and intestinal
dilation. Loops in the small intestine are dilated when their diameter exceeds 3 cm.
For the cecum this is more than 9 cm and for the remainder of the colon more than 6
cm. An ileus may develop in the small or large intestine or in both, and may have
various causes. The causes are subdivided into two groups: paralytic ileus and
mechanical ileus.
 DAFTAR PUSTAKA
• https://radiopaedia.org/cases/normal-multi-p
hase-ct-of-the-abdomen?lang=us
• https://radiopaedia.org/articles/ct-abdomen-s
ummary?lang=us
• http://www.startradiology.com/internships/ge
neral-surgery/abdomen/ct-abdomen-general/
TERIMA KASIH 