Upper abdominal computed tomography with intravenous contrast injection

The article is professionally consulted by Master, Doctor Trinh Thi Phuong Nga - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital.

Contrast-enhanced upper abdominal computed tomography is a technique that uses a multi-slice computed tomography machine to reconstruct the entire upper abdominal structure and allow assessment and detection of abnormalities. , pathological lesions in the survey area.

Upper abdominal computed tomography with intravenous contrast is the use of a multi-receiver computerized tomography machine with the application of X-rays and algorithms to capture and reconstruct images of organs in the upper abdomen. upper abdominal cavity such as liver, biliary tract, gallbladder, pancreas, spleen, two kidneys, adrenal glands, stomach, intestines, colon, blood vessels ....
In addition to evaluating the parenchyma of the viscera, Computed tomography of the upper abdomen with contrast injection (using iodinated contrast agent) in the form of intravenous injection also allows the morphological and pathological evaluation of the blood vessels supplying the organs in the upper abdomen, as well as such as vascular pedicles and drainage of malformed blood vessels, lesions in tumor cases if present....

Intravenous contrast-enhanced upper abdominal computed tomography is indicated in clinical examination to help detect abnormalities in visceral organs such as:
● Liver: Liver lesions including trauma injury, liver abscess, hepatitis, liver tumor ... .
● Biliary tract, gallbladder: anatomical assessment, detection of diseases in the biliary tract and gallbladder, including: bile duct stones, gallstones, tumors, cysts, inflammation ... .
● Pancreas and pancreatic duct: Pathologies in the pancreas including acute and chronic pancreatitis, pancreatic tumors, pancreatic duct stones, cysts....
● Spleen: Lesions in the spleen such as: trauma, tumors , splenic vein thrombosis, ....
● Two kidneys: Detecting pathologies in the renal parenchyma such as: tumors, cysts, inflammation, infarction ...., or pathologies in the calyces and renal pelvis such as: fluid retention, stones, tumors, inflammation....
● Adrenal tumors on both sides.
● Stomach, duodenal: Lesions in stomach, duodenum such as: gastrointestinal bleeding, tumor....
● Bladder: stone, tumor, ....
● Patient before or after Upper abdominal organ transplant surgery.
● Many other lesions: Abscess under the diaphragm, mesenteric tumor, mesenteritis, perforation of hollow viscera, tumor or peritonitis, free or localized fluid.....
● Diseases in the posterior compartment peritoneum: Tumor, fibrosis, blood vessels....
Arterial and venous lesions: Thrombosis of portal vein or hepatic vein in liver cancer; thrombosis of the branches of the visceral trunk or superior and inferior mesenteric arteries, renal artery stenosis causing hypertension....
Note, upper abdominal computed tomography with intravenous contrast injection may have absolute contraindication (previous allergy to contrast) or relative to patients with renal failure, history of allergy in general excluding contrast, pregnant women in the first weeks should be considered. indicated (need to be examined and consulted by a specialist to have the necessary precautions...).

Computed tomography of the upper abdomen with contrast injection is performed including the following steps to prepare the patient:
Step 1: The patient is placed supine on the imaging table, arms raised above the head to limit image noise reduction. The technician instructs and asks the patient to hold their breath to avoid image noise.
● Step 2: Set up an intravenous line to inject contrast. The dose of iodinated contrast media is from 1.5 to 2 ml/kg body weight. Use a syringe pump to inject rapidly at a rate of 3 - 4 ml/s, depending on the strength of the vessel wall.
● Step 3: Computed tomography with transverse layers of the upper abdomen before contrast injection for localization. Assess lesion components including fat, bleeding, or calcification by density measurement of the suspected lesion. Compare the density of the lesion area after contrast injection to assess the extent of drug permeability of the viscera, more or less damaged blood vessels. The cut layers taken before injection were 5mm thick, and 2.5mm after injection. Depending on the size of each individual in the upper abdominal cavity and to evaluate the entire skeletal system, fat, air, soft tissue, the technician will change the appropriate field of view and the corresponding window width.
Step 4: Take scans in the arterial phase after contrast injection from 25 to 30 seconds to evaluate conditions including: blood supply to the tumor, parenchymal perfusion disorders in the affected areas. solid organs, detecting venous drainage in arteriovenous and venous malformations, and visceral trauma leading to drug drainage.
Step 5: Take the scans in the venous phase after contrast injection from 60 to 70 seconds to assess the status such as: the degree of drug clearance of the tumor, and at the same time detect trauma that ruptures the stratum corneum on the abdomen. Depending on the patient's case, the technician conducts the CT scans at a later time, about 3 - 10 minutes after contrast injection.
● Step 6: The technician reproduces the computed tomography image of the upper abdomen with layers of 1mm thickness, the blood vessels are erected in different directions. Each viscera was examined for its own arterial and venous system. The image results must be clear and free of noise so that the doctor can diagnose and detect abnormalities, if any.

Computed tomography of the abdomen with contrast injection is a modern technique, the risk of radiation contamination is managed, contrast is used only to change the density of the internal organs temporarily to serve the diagnosis. Picture . However, in some very rare cases, reactions to contrast can occur with the following degrees:
● Mild: body heat, restlessness, nervousness, nausea and vomiting, itching, hives or a mild rash.
● Moderate: Low or high blood pressure, shortness of breath, wheezing, heart rhythm disturbances, severe hives or rash.
● Severe: Swollen throat, difficulty breathing, convulsions, low blood pressure, cardiac arrest, swelling of some other parts of the body, anaphylaxis....
Cases where the patient is allergic to contrast agents X-ray is contraindicated with intravenous contrast-enhanced upper-abdominal computed tomography, therefore, in most cases, it is indicated, if the allergy is present, it is usually only mild. and if it is severe, it will be treated according to the allergy protocol.
Upper abdominal computed tomography with intravenous contrast is a modern imaging technique to help find and detect pathological abnormalities or injuries in viscera such as liver, pancreas, spleen, ... if any.

Vinmec International General Hospital has applied modern examination techniques to improve the quality of medical examination and treatment for all customers, including a new and modern multi-sequence computerized tomography system. most today. Accordingly, the doctors who carry out the procedures are all well-trained doctors with high expertise, thus giving accurate results, making a significant contribution to the identification of the disease and the stage of the disease. offer the optimal treatment regimen for customers.
Doctor Trinh Thi Phuong Nga is a radiologist with nearly 20 years of experience in diagnostic imaging. Currently, the doctor is working at - Department of Diagnostic Imaging - Vinmec Times City International General Hospital.
To register for examination and treatment at Vinmec International General Hospital, you can contact the nationwide Vinmec Health System Hotline, or register online HERE.