Abdominal CT scan

Studying CT of abdomen

1. Abdominal CT scan Department of radiology Submitted by, AL AUF JALALUDEEN Group: 308

2. An abdominal  CT scan  is an imaging method that uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomography . How the Test is Performed You will lie on a narrow table that slides into the center of the CT scanner. Most often, you will lie on your back with your arms raised above your head. Once you are inside the scanner, the machine's x-ray beam rotates around you. Modern spiral scanners can perform the exam without stopping. A computer creates separate images of the belly area. These are called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the belly area can be made by stacking the slices together. You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.

3. Why the Test is Performed An abdominal CT scan makes detailed pictures of the structures inside your belly (abdomen) very quickly. This test may be used to look for: Cause of abdominal pain or swelling Hernia Cause of a fever Masses and tumors, including cancer Infections or injury Kidney stones Appendicitis

4. What Abnormal Results Mean The abdominal CT scan may show some cancers, including: Cancer of the renal pelvis or ureter Colon cancer Hepatocellular carcinoma Lymphoma Melanoma Ovarian cancer Pancreatic cancer Pheochromocytoma Renal cell carcinoma  (kidney cancer) Testicular cancer

5. The abdominal CT scan may show problems with the gallbladder, liver, or pancreas, including: Acute cholecystitis Alcoholic liver disease Cholelithiasis Pancreatic abscess Pancreatic pseudocyst Pancreatitis Blockage of bile ducts

6. The abdominal CT scan may reveal the following kidney problems: Acute bilateral obstructive uropathy Acute unilateral obstructive uropathy Chronic bilateral obstructive uropathy Chronic unilateral obstructive uropathy Complicated UTI (pyelonephritis) Kidney stones Kidney or ureter damage Polycystic kidney disease

7. Abnormal results may also be due to: Abdominal aortic aneurysm Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal artery stenosis Renal vein thrombosis

8. Studying the CT image In this sequence of images, we will label the abdominal vasculature. The CT images are 5mm slices with soft tissue window settings. IV and oral contrast have been administered which causes the vessels and GI tract to appear hyperdense (white). Some images will contain labels to assist with tracking the vessels . IMAGES ARE VIEWED AS LOOKING FROM THE FEET RIGHT LEFT

9. Follow the IV contrast filled Aorta as we descend caudally. Branches and points of interest will be noted.

10. Azygous Vein. Hemiazygous Vein

11. This is an excellent image of the right, middle and left hepatic veins draining into the Inferior Vena Cava. Don’t confuse this structure with the IVC, this is the esophagus at the level of the Lower esophageal sphincter, page up and down to confirm this.

12. The outline of the Inferior Vena Cava is more distinct in this image.

13. Portal Vein Branching into the Liver Liver Stomach

14. More portal vein branching into the liver lobes

15. Splenic Artery . Splenic Vein. Scroll up and down to confirm. Spleen

16. Splenic Vein

17. Proper Hepatic Artery . Splenic Vein Portal vein Adrenal Glands

18. You can see the Celiac artery starting to branch from the Aorta. You can follow this down in the next four images Proper Hepatic Artery is labeled in the upper right The splenic vein and artery are in the lower left

19. Proper Hepatic Artery and Splenic Artery (the splenic artery is the circle). Splenic Vein

20. Here the Splenic Vein is emptying into the portal vein. Follow this up and down. Pancreas

21. This is the Superior Mesenteric Artery branching off the Aorta.

22. Rt. and Lt.Kidneys Pancreas

23. Renal Veins emptying into the IVC . We also see the right renal artery branching off the Aorta , follow it down till you see it enter the right kidney. The Superior Mesenteric Vein is outlined on the top of this image. If you follow the SMV up, you will see it empty into the Portal Vein.

24. Here we see the right and left renal vein entering into the Inferior Vena Cava . We Also see the left renal artery branching off the aorta and heading toward the left kidney. Page up and down to trace these vessels.

25. Superior Mesenteric Vein – follow it up as it joins the Splenic Vein to form the Portal Vein

26. Transverse Colon Small Bowell

27. Note inferior mesenteric artery emerging from aorta Inferior mesenteric vein extends cephalad to join smv.

28. Aorta bifurcates into common illiac arteries Appendix is noted coiling in Rt. Lower quadrant Note air in lumen on adjacent scans Psoas muscles

29. 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.

30. RENAL CYST                                                                                                                                                                             NO CONTRAST CONTRAST

31. HEPATOMEGALY

32. SPLENOMEGALY

33. DIVERTICULITS

34. ABDOMINAL ABSCESS Psoas abscess (blue arrow), and abscess dissecting anteriorly in transversalis fascia.

35. BOWEL OBSTRUCTION                                                                                                                                                                                       

36. RENAL STONE                                               

37. 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

38. CIRRHOSIS

39. CHOLELITHIASIS

40. CHOLECYSTITIS

41. PANCREATIC CANCER

42. PANCREATITIS

43. ABDOMINAL ANEURYSM