ABSTRACT
AIM: Abdominal computed tomography (CT) improves the accuracy of clinical diagnosis and facilitates patient management. Radiation exposure must be considered by requesting clinicians and is especially relevant owing to the increasing use of CT colonography for diagnosis and screening of colorectal disorders. This review describes the radiation dose of abdominopelvic CT and colonography and attempts to quantify the risk for the clinician. METHOD: Articles were searched in the PubMed and Medline databases using combinations of the MeSH terms 'radiation', 'abdominal computed tomography' and 'colonography'. Electronic English language abstracts were read by two reviewers and the full article was retrieved if relevant to the review. RESULTS: Abdominopelvic CT and CT colonography convey significant radiation dose to the patient but also have considerable diagnostic potential. In the right clinical context, the radiation risk should not be overestimated. Techniques to reduce the dose should be used. Repeated imaging in certain patients is a concern and should be monitored. CONCLUSION: Radiation risk can be quantified and presented simply in a manner that both patients and doctors can comprehend and evaluate. This approach will diminish misconceptions and allow a rational choice of diagnostic test.
Subject(s)
Colorectal Surgery , Health Knowledge, Attitudes, Practice , Radiation Dosage , Radiation Injuries/etiology , Tomography, X-Ray Computed , Colonography, Computed Tomographic/adverse effects , Communication , Humans , Pelvis/diagnostic imaging , Radiography, Abdominal/adverse effects , Risk Assessment , Tomography, X-Ray Computed/adverse effectsSubject(s)
Aneurysm, Infected/diagnosis , Aortic Aneurysm/diagnosis , Iliac Aneurysm/diagnosis , Staphylococcal Infections/diagnosis , Staphylococcus aureus/isolation & purification , Aneurysm, Infected/complications , Aortic Aneurysm/complications , Cervical Vertebrae/diagnostic imaging , Discitis/complications , Discitis/diagnosis , Fatal Outcome , Femoral Artery , Fluorodeoxyglucose F18 , Humans , Iliac Aneurysm/complications , Lumbar Vertebrae/diagnostic imaging , Male , Middle Aged , Multimodal Imaging/methods , Popliteal Artery , Positron-Emission Tomography , Radiopharmaceuticals , Sepsis/complications , Staphylococcal Infections/complications , Tomography, X-Ray ComputedABSTRACT
INTRODUCTION: Gastrointestinal (GI) perforation is a common surgical presentation. In recent years, computed tomography (CT) has been shown to be accurate for predicting the site of GI perforation, and has become the investigation of choice. However the signs may be subtle or only indirectly related to the site or aetiology of perforation. SUBJECTS AND METHODS: A MEDLINE and PubMed search was performed for journals before June 2009 with MeSH major terms 'CT' and 'perforation'. Non-English speaking literature was excluded. RESULTS: Examples of GI perforation of various aetiologies are reviewed (inflammatory, neoplastic, traumatic and iatrogenic) high-lighting characteristic CT appearances as well as pitfalls in diagnosis. Features of perforation include the presence of free gas or fluid within the supra- and/or inframesocolic compartments, segmental bowel wall thickening, bowel wall discontinuity, stranding of the mesenteric fat and abscess formation. CONCLUSIONS: These differentiating features facilitate accurate multidisciplinary pre-operative evaluation, necessary to plan patient management and potential surgical approach.
