THE IMPACT OF 16 SLICE MDCT ON THE IMAGING OF COMMON ACUTE ABDOMEN CASES IN U.A.E

Abstract

The aim of this study is to identify the impact of imaging common acute abdominal diseases using the modern multi-row detectors CT scanners (MDCT ). Comparative study of fifty (50) positive cases of five common acute diseases, cholecystitis, pancreatitis, appendicitis, small bowel obstruction, and renal colic due to ureteric calculi was done . All 50 cases has been imaged by 16 slice MDCT scanner, US and/or plain filming. The results are correlated with surgical and medical findings The study shows reliable results in diagnosis of common acute abdominal diseases under study by MDCT scanners. 95% accuracy in detection of hepatobiliary diseases was recorded. 100% accuracy in detection of GB calculi compared to 90% for US .80% accuracy in detection of CBD calculi was recorded compared to 30% accuracy US of ductal stones. All of the cases of GB, CBD calculi undergone surgery at Madinat Zayed hospital.70% of pancreatitis cases were diagnosed by MDCT .(30%) does not show radio logic finding related to pancreatitis. 50% were diagnosed by US, but MDCT revealed additional diagnosis in 50% of the 10 cases studied (5 cases) these includes, a CBD calculus vi Pancreatic cysts, 2 cases psoedopancreatic cysts and a case of pancreatic stones. 100% accuracy in detection of ureters calculi is recorded. compared to 40% are detect by US depending on location of the calculus. 50% of the ureter calculi were seen in plain film. 70% accuracy in detection of small bowel obstruction was recorded . MDCT shows 90% accuracy in detection of appendicitis compared to 80% for US. The MDCT also revealed relevant alternate or additional diseases, which changes management of treatment in 30% of the cases. 3 cases diagnosed clinically as appendicitis proves to be gynecological problem, of ovarian cysts, intrauterine cyst and distal ureters calculus. Survey on the MDCT performance, the number of eligible participants from the radiologist was 15, physicians and surgeons was 14 and 11 CT technologists. 90% of the participant has more than 5 years experience. All participants have MDCT at their departments.77% are frequent users of MDCT, 22.5% use the scanner sometimes . In response to the core question regarding the recommended standard investigation for acute abdomen, only 2.5% recommend plain x-ray, 10% recommended US, 15% recommended MDCT alone ,while 47.5% recommended U/S and MDCT, indicating that MDCT is a centeral modality for imaging acute cases . 52.5% rated MDCT as highly recommended , while 47.5 % recommended MDCT for investigation for some acute abdominal cases. All participants agreed that MDCT improved the efficiency of radiology department, the majority 62% agreed that image quality, type of investigation and number of exams are the main aspects of improvement, vii 55% responded that data management and radiation dose are future challenges for MDCT users. This thesis provide evidence that MDCT scanner is a reliable and effective modality for investigation and detection of common acute abdomen pathology .