The Role of CT Scanning In the Investigation of Biliary and Pancreatic Conditions
Apr 01, 2015
The Role of CT ScanningIn the Investigation of Biliary
and Pancreatic Conditions
Computerised Axial Tomography
X-ray tube that rotates around your body◦ Whilst you lay flat on a bed non-invasive◦ Produces slices of the body
Provide more detail than standard X-rays
Scans take 10 – 30 minutes depending on location
Can be done with contrast to enhance images
CT Scanning
NHS Choices (2012)
http://www.siemens.co.in/pool/press/news_archive/somatom_definition_as17.jpg
Gold Standard Imaging technique essential Done as contrast CT unless Haemorrhage suspected
Pancreatitis done after 72 hours◦ Assess levels of necrosis ◦ Signs of fluid collection or abscess formation◦ Pseudocyst development
Carcinoma confirm the presence of lesion◦ Determination of whether legion is operable◦ Determine whether metastasis has occurred
Pancreas
UCSD Radiology Dept (2009)Kumar & Clark (2012)
Demos T C et al. (2002)
Cystic fibrosis with cystosis in 33-year-old man.
Demos T C et al. AJR 2002;179:1375-1388
©2002 by American Roentgen Ray Society
Lymphoepithelial cyst in asymptomatic 54-year-old woman.
Demos T C et al. AJR 2002;179:1375-1388
©2002 by American Roentgen Ray Society
Cholecystitis observation of signs of inflammation◦ Determine any complications signs of gas or abscesses◦ Calcification porcelain gallbladder
Gallstones Alternative method◦ Opaque stones more readily detected
Exclusion of other causes of obstruction◦ Carcinoma at the head of the pancreas
Carcinoma observation of masses solid/polypoid◦ Observation of asymmetric or symmetric wall thickening
Biliary
Grand D et al. AJR (2004)Kumar & Clark (2012)
Contrast-enhanced CT scan obtained in 45-year-old man shows low-density gallstones.
Grand D et al. AJR 2004;183:163-170
©2004 by American Roentgen Ray Society
Contrast-enhanced CT scan obtained in 72-year-old man with emphysematous cholecystitis reveals air in gallbladder lumen and thickening of wall.
Grand D et al. AJR 2004;183:163-170
©2004 by American Roentgen Ray Society
NHS Choices (2012) NHS
http://www.nhs.uk/Conditions/CT-scan/Pages/Introduction.aspx University College San Diego Radiology Department (2009)
http://radiology.ucsd.edu/body_image/pdfs/physician/body_ct_protocols5-26-09.pdf CT of the Gallbladder: Spectrum of Disease, Grand, D, Horton, K.M, Fishman, E. American
Journal of Roentgenology July 2004 vol. 183 no. 1 163-170 ARRS http://www.ajronline.org/content/183/1/163.full
Cystic Lesions of the Pancreas, Demos, T.C., Posniak, H.V., Harmath, C, Olson, M.C., Aranha, G., American Journal of Roentgenology December 2002 vol. 179 no. 6 1375-1388 ARRS
http://www.ajronline.org/content/179/6/1375.full Kumar & Clark’s Clinical Medicine, 8th Edition (2012) Kumar, P & Clark, M, Elsevier
References