Imaging of large bowel with multidetector row CT

Abstract

The use of high-resolution multidetector CT (MDCT) has revolutionized evaluation of the large bowel in both the acute emergency room setting and in chronic conditions. The physical exam is often limited and CT can help differentiate between conditions that may mimic each other clinically. Patients often present with vague abdominal symptoms, and CT can help elucidate the etiology and help guide management and treatment. The pathology is vast, and some of the more common acute conditions include appendicitis, diverticulitis, inflammatory bowel disease, and bowel obstruction. More recently, CT has also come to play a significant role in the evaluation of acute lower gastrointestinal bleeding. Primary evaluation with CTA has become accepted as an alternative initial screening exam and has been incorporated into the algorithm and work-up of lower gastrointestinal bleeding in many large medical centers. CTA allows for a quick and efficient survey of the abdomen and can triage patients appropriately, ensuring accurate, timely, and safe management. Considerable improvements have also been made in colorectal cancer screening with CT colonography (CTC, also known as virtual colonoscopy). The American Cancer Society (ACS) and US Preventive Services Task Force (USPSTF) now recognize CTC as an acceptable primary screening option for colorectal cancer, which should pave the way for more widespread usage.