CT for upper abdominal pathology - is imaging of the pelvis necessary?
Background. Current practice at our institution for routine abdominal
CT includes coverage from the diaphragm to the symphysis pubis and therefore includes pelvic organs. Limited upper abdominal imaging exists in other modalities, and tailoring the examination to pathology will result in higher positive yield. Objective. To determine if the pelvic component of a routine abdominal CT scan contributes to the final diagnosis in organ-specific upperabdominal pathology. Methods. This was a retrospective study spanning a 14-month consecutive period; all abdominal CTs for organ-specific upper-abdominal
pathology were included. There were no age or gender limitations. Patients with multi-organ involvement such as lymphoma and TB were excluded. The consultant radiologists' reports were evaluated for the indication, preceding investigations, presence of pelvic pathology and final CT diagnosis. Results. Of 133 CT studies done, 116 did not show any abnormality in the pelvis. In 3 cases there were pelvic abnormalities that contributed to
making the final diagnosis. Independent review of these cases by 4 consultant radiologists with masking of the pelvic cuts did not influence the final outcome. In 5 cases free fluid was noted and in 9 cases there were incidental findings with no impact on the final diagnosis.
Conclusions. It is not essential to include the pelvis in the field of radiation in scanning specific upper-abdominal pathology, with the exclusion of staging a known renal mass and imaging renal calculi.
South African Journal of Radiology Vol. 11 (1) 2007: pp. 14-18