RadteraCT Abdomen and Pelvis With Contrast (Routine)
CT+ ContrastAbdomen & Pelvis
Indications
- Abdominal/pelvic pain of unclear etiology
- Suspected infection/abscess, diverticulitis, appendicitis, colitis
- Oncologic staging/restaging and follow-up
- Bowel obstruction, inflammatory bowel disease
- Solid organ assessment (liver, spleen, pancreas, kidneys, adnexa)
Patient prep
- Screen eGFR/contrast allergy; premedicate if indicated
- NPO ~2-4 h before exam (reduces aspiration risk, allows gastric emptying)
- Oral contrast (neutral water or positive) per indication/site (~600-1000 mL over 45-90 min); often omitted for renal colic, acute GI bleed, or rapid trauma
- IV access 18-20 G; supine, arms up
Contrast
Agentiodinated (e.g. iohexol 350 or iopamidol 370)
RouteIV (+/- oral)
Dose≈100-125 mL at 2.5-3.5 mL/s (weight-based ~1.5 mL/kg) with saline flush
TimingSingle portal venous phase ~65-80 s (fixed delay or bolus tracking) for routine; add arterial ~30-35 s for liver/pancreas/vascular questions
Technique
- Supine, arms up; helical volume from dome of diaphragm through pubic symphysis/ischial tuberosities
- Single end-expiratory or comfortable breath-hold (abdomen)
- 120 kV (100 kV smaller patients); mAs per scanner with AEC; iterative reconstruction
- Reconstruct soft-tissue 3-5 mm axial plus thin 1.25-2 mm source; coronal and sagittal reformats standard
- Bolus tracking ROI in abdominal aorta or fixed delay
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial portal venous | axial | 3-5 mm | Standard kernel; primary diagnostic series |
| 2 | Thin axial source | axial | 1.25-2 mm | For reformats and small-structure assessment |
| 3 | Coronal reformat | coronal | 3 mm | Bowel, mesentery, overall survey |
| 4 | Sagittal reformat | sagittal | 3 mm | Spine, pelvis, presacral |
Key points
- Single portal venous phase covers most routine indications; add arterial phase for hypervascular liver lesions, pancreatic protocol, GI bleed, or vascular questions
- Coronal reformats markedly improve bowel/obstruction and appendicitis evaluation
- Tailor oral contrast: positive for abscess/leak/postop, neutral/none for renal colic, mesenteric ischemia or CT enterography
- Weight-based contrast dosing optimizes enhancement; keep dose ALARA with AEC + iterative recon
References
• ACR–SAR–SPR Practice Parameter for the Performance of CT of the Abdomen and Pelvis
• ACR Appropriateness Criteria: Acute Nonlocalized Abdominal Pain; Right Lower Quadrant Pain
• Radiopaedia: CT abdomen-pelvis (protocol) link
• RadioGraphics: Multidetector CT of Acute Abdomen
• ACR Appropriateness Criteria: Acute Nonlocalized Abdominal Pain; Right Lower Quadrant Pain
• Radiopaedia: CT abdomen-pelvis (protocol) link
• RadioGraphics: Multidetector CT of Acute Abdomen
Source: Researched — verify against your institution
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Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.