Contrast Material: For abdominal CAT cans, the patient is given a cup of dilute barium or Gastrograffin the night before and also 1 hour before the Scan to delineate the small and large bowel. The CAT Scan may be done twice, first before and then after intravenous iodinated contrast (Same iodinated IV contrast used for IVP test see above). The iodinated contrast enhanced the vascular structures and improved interpretation of the CAT Scan images.
CT (CAT) Scan COMMENTS?
CAT SCAN of the Abdomen
Computerized Axial Tomography
Introduction:The CAT Scan machine was invented by Dr. Hounsfield. It is a x-ray tube that rotates around the patient making many pictures as it rotates. The multiple x-ray pictures are then reconstructed by a computer, producing axial images of the body. It thus look into the body in a similar fashion as you can look into a salami by cutting it in slices.
This is a typical CAT SCAN Machine: notice the hole in the middle of the gantry for the patient table.
The CAT Scan machine looks like a large donut standing up (called the gantry) on its side with a table going though the center of it. The patient lies on the table as the table is moved slowly into the scanner gantry (Donut). The gantry houses the rotating x-ray tube and x-ray receptors. The original scanners in 1978 took 2 minutes per slice and had very rough images. The new scanners today can do a series of 30 images in a few seconds and have much sharper images.
Possible Risks and Complications: The IV contrast is usually injected with a motor driven injector and so leakage from the vein can occur. This will cause local irritation of the skin. There is also a risk of allergy to the iodinated contrast material resulting in hives, itching, wheezing, shock etc. Pretreatment with Benadryl and Predisone usually eliminates reaction in allergic patients. Example of CAT scans of the Abdomen:
 Cat scan with IV contrast shows abdominal aortic aneurysm (red arrows) |
 Cat scan shows cancer at two locations destroying the pelvic bones. (red arrows) |
Case Demonstration
26 year old male with abdominal pain has a CAT scan of the abdomen which shows enlargement
of the pancreas and bulky enlarged peri-aortic lymph node masses (circled in blue).
Our initial thought was that this mass was probably a lymphoma.
CAT Scan guided percutaneous needle biopsy shown at left.
Biopsy needle and mass indicated by red arrow and red circle.
Patient is prone on CAT table and the biopsy needle is shown extending into periaortic node mass. Biopsy revealed pancreaticoblastoma, a rare pancreatic germ cell tumor.
The patient was treated with a course of chemotherapy by the oncologist . Following treatment, a repeat CAT scan of the abdomen shows regression of the tumor masses. (see below)
Repeat CAT SCAN after chemotherapy treatment shows marked regression of the retroperitoneal masses shown at left.
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