Contrast Not Always Necessary for MDCT for Abdominal Pain

November 18, 2015

Multidetector CT without oral contrast can be effective on larger patients presenting with acute abdominal pain.

Contrast is not needed for all patients undergoing multidetector CT (MDCT) for investigation of acute abdominal pain in the emergency room, according to a study published in the Canadian Association of Radiologists Journal.

Researchers from Canada performed a retrospective study to determine if eliminating oral contrast for MDCT affected the detection of acute abdominal abnormalities in patients presenting to the ER.

A total of 375 patients were included in the study, which took place from November 1, 2102 to October 21, 2013. There were 174 males and 201 females, with a mean age of 57. All patients presented with complaints of acute abdominal pain, and their body mass index was above 25. Patients who had BMI of less than 25 were given the oral contrast.[[{"type":"media","view_mode":"media_crop","fid":"43479","attributes":{"alt":"oral contrast","class":"media-image media-image-right","id":"media_crop_2989958619925","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4745","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 100px; width: 100px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©Mr Aesthetics/Shutterstock.com","typeof":"foaf:Image"}}]]

The results showed that seven of 375 (1.9%) of the patients required a repeat CT examination with oral contrast within seven days of their initial scan, although none of these patients required a change in the course of their management following the scan with the oral contrast. No delayed or missed diagnoses related to the absence of oral contrast were identified.

The authors concluded that patients with a BMI over 25 who presented to the ER with acute abdominal pain did not require oral contrast for MDCT, which allows for quicker screening.