Department of Radiology, Boston University Medical Center, 820 Harrison Ave, Boston, MA 02118, USA.
Radiographics. 2009 Oct;29(6):1767-80. doi: 10.1148/rg.296095509.
Accurate and rapid diagnostic imaging is essential for the appropriate management of acute gastrointestinal conditions. Computed tomography (CT) is the modality most often used in this setting because of its widespread availability and the relative speed, ease, and uniformity with which evaluations can be performed. CT allows the diagnosis of a wide spectrum of acute gastrointestinal diseases with the adjustment of only a few variables in the acquisition protocol. For example, the contrast material volume, injection rate, and delay before image acquisition can be manipulated to enhance vascular or organ-specific contrast for myriad gastrointestinal diagnoses. Magnetic resonance (MR) imaging has similarly robust potential, although its integration into the acute care setting requires greater technical and logistical effort. Improved MR imaging sequences, advances in coil technology, streamlined imaging protocols, and increased technical and professional familiarity with the modality make it an increasingly attractive option when there is concern about patient radiation exposure or allergy to iodinated contrast material. A variety of acute abdominal conditions, including pancreatic and biliary tract trauma, choledocholithiasis, gallbladder disease, acute pancreatitis, and appendicitis can be rapidly and accurately demonstrated with MR imaging. MR imaging also can play a vital role in the follow-up assessment of treatment response and in the diagnosis of indeterminate findings at CT or ultrasonography. Nevertheless, incompatibility of patient monitoring devices with the MR magnet, lack of MR imaging system availability, and the acuity of illness may limit the use of the modality.
准确快速的诊断成像对于急性胃肠道疾病的适当治疗至关重要。由于其广泛的可用性以及可以相对快速、轻松且一致地进行评估，计算机断层扫描 (CT) 是该环境中最常使用的方法。CT 可以通过调整采集协议中的几个变量来诊断广泛的急性胃肠道疾病。例如，可以操纵对比材料的体积、注射速度和图像采集前的延迟，以增强无数胃肠道诊断的血管或器官特异性对比。磁共振 (MR) 成像也具有类似的强大潜力，尽管其集成到急性护理环境中需要更多的技术和后勤工作。改进的 MR 成像序列、线圈技术的进步、简化的成像协议以及对该方式的技术和专业熟悉程度的提高，使得当患者对辐射暴露或碘对比材料过敏时，它成为一个越来越有吸引力的选择。各种急性腹部疾病，包括胰腺和胆道创伤、胆总管结石、胆囊疾病、急性胰腺炎和阑尾炎，都可以通过 MR 成像快速准确地显示。MR 成像还可以在治疗反应的随访评估和 CT 或超声检查中不确定发现的诊断中发挥重要作用。然而，患者监测设备与磁共振磁体不兼容、磁共振成像系统可用性不足以及疾病的紧迫性可能会限制该方式的使用。
