Paolantonio Pasquale, Rengo Marco, Ferrari Riccardo, Laghi Andrea
1 Department of Radiology, San Giovanni Hospital, Rome, Italy.
2 Department of Radiological Sciences, Oncology and Pathology, Sapienza-University Rome, Polo Pontino, ICOT Hospital, Latina, Italy.
Br J Radiol. 2016;89(1061):20150859. doi: 10.1259/bjr.20150859. Epub 2016 Jan 22.
Multidetector CT (MDCT) is an imaging technique that provides otherwise unobtainable information in the diagnostic work-up of patients presenting with acute abdominal pain. A correct working diagnosis depends essentially on understanding the individual patient's clinical data and laboratory findings. In haemodynamically stable patients with acute severe and generalized abdominal pain, MDCT is now the preferred imaging test and gives invaluable diagnostic information, also in unstable patients after stabilization. In this descriptive review, we focus our attention on acute, severe and generalized or undifferentiated non-traumatic abdominal pain. The main differential diagnoses are acute pancreatitis, gastrointestinal perforation, ruptured abdominal aneurysm and acute mesenteric ischaemia. We will provide radiologist readers with a technical guide to optimize MDCT imaging protocols and list the major CT signs essential to reach a correct diagnosis and guide the best treatment.
多排螺旋CT(MDCT)是一种成像技术,在对急性腹痛患者的诊断检查中可提供其他方式无法获得的信息。正确的工作诊断主要取决于对个体患者临床数据和实验室检查结果的理解。对于血流动力学稳定的急性严重全腹痛患者,MDCT现在是首选的成像检查,并且在稳定后的不稳定患者中也能提供宝贵的诊断信息。在本描述性综述中,我们将注意力集中在急性、严重、全腹或未分化的非创伤性腹痛上。主要的鉴别诊断包括急性胰腺炎、胃肠道穿孔、腹主动脉瘤破裂和急性肠系膜缺血。我们将为放射科读者提供一份技术指南,以优化MDCT成像方案,并列出正确诊断和指导最佳治疗所必需的主要CT征象。