Emergency Radiology

, Volume 16, Issue 1, pp 61–70

Acute abdominal pain: value of non-contrast enhanced ultra-low-dose multi-detector row CT as a substitute for abdominal radiographs

Authors

    • Division of Abdominal Imaging, Department of RadiologyEmory University School of Medicine
  • Jianhai Li
    • Division of Abdominal Imaging, Department of RadiologyEmory University School of Medicine
  • Deborah A. Baumgarten
    • Division of Abdominal Imaging, Department of RadiologyEmory University School of Medicine
  • William C. Small
    • Division of Abdominal Imaging, Department of RadiologyEmory University School of Medicine
  • Mannudeep K. Kalra
    • Department of RadiologyMassachusetts General Hospital
Original Article

DOI: 10.1007/s10140-008-0743-0

Cite this article as:
Udayasankar, U.K., Li, J., Baumgarten, D.A. et al. Emerg Radiol (2009) 16: 61. doi:10.1007/s10140-008-0743-0

Abstract

The aim of this study was to evaluate a non-enhanced ultra-low-dose (ULD) abdominal–pelvic multi-detector row computerized tomography (MDCT) to assess patients with acute abdominal pain who would otherwise undergo three-view abdominal X-ray series. Institutional review board approval was obtained with waiver of informed consent. This study was Health Insurance Portability and Accountability Act-compliant. One hundred and sixty-three patients (mean age, 51 years; range, 19–82 years, M/F = 110:53) who underwent ULD MDCT were included in the study. Two subspecialty radiologists independently reviewed the images for abnormal findings and image quality parameters. The effective radiation dose was calculated for each patient and compared to standard-dose computed tomography (CT) scans of 50 matched controls. Findings were confirmed by reviewing the patients’ medical records, and statistical analysis was performed. ULD MDCT showed a high sensitivity (100%), specificity (98.5%), and positive predictive value (91.7%) for detection of free air, stones, and intestinal obstruction. For other sources of abdominal pain, the overall sensitivity, specificity, and positive predictive value were 86%, 96%, and 95%, respectively. Mean effective radiation dose from this study was 2.10 mSv (range of 0.67 to 6.64 mSv) with a 78% mean dose reduction compared to standard-dose CT. There was good inter-observer agreement (=0.4 to 0.81). ULD abdominal–pelvic MDCT provides rapid and reasonably accurate diagnostic information in patients with acute abdominal pain at a very low radiation dose.

Keywords

Ultra-low dose CT Acute abdomen

Copyright information

© Am Soc Emergency Radiol 2008