Procedure Name Computed Transaxial Tomography, Pelvis

Synonyms Lower Abdomen, CT; Pelvis, CT

Procedure Commonly Includes CT scan pelvic area includes bladder, prostate, ovaries, uterus, lower retroperitoneum, and iliac lymph node chains

Indications Evaluation of cysts, tumors, masses, metastasis, inflammatory processes, and lymphadenopathy

Contraindications Uncooperative patient

Patient Preparation Dietary restrictions include fluids only for 4 hours prior to the examination. Medication schedule should not be interrupted. Intravenous contrast material may be administered. This is at the discretion of the radiologist. A recent serum creatinine is requested in all patients 60 years of age and older and those patients with known significant atherosclerotic disease, diabetes mellitus, or pre-existing renal disease, in case intravenous contrast administration is necessary. 450 mL dilute barium (1%) is administrated orally commencing at least 1 hour prior to the examination. This facilitates good opacification of the small bowel. A small volume (4-8 oz) of dilute contrast material is given per rectum to facilitate opacification of the distal large bowel. In the case of females, placement of a vaginal tampon may be helpful in further defining the anatomy.

Special Instructions A CT study of the pelvis may be requested by a practicing physician. The patient's medical record should accompany them to furnish the radiologist with adequate clinical information thus facilitating tailoring of the examination to ensure maximum diagnostic benefit.

Technique Study may be performed on any one of the many commercially available computed tomographic scanners. Sequential 1 cm slices are obtained from the pelvic brim through the pubic symphysis. Intravenous administration of contrast material facilitates opacification of the major vascular structures in addition to the ureters and urinary bladder. Oral contrast, rectal contrast, and a vaginal tampon aid in defining the anatomy within the pelvis.

Causes for Rejection The presence of residual concentrated barium deposits within the large bowel secondary to a prior gastrointestinal exam, creates artifacts which usually detracts from diagnostic usefulness of the study. Where possible, CT studies of the abdomen and pelvis should be completed before conventional gastrointestinal barium examinations. Should these studies be performed in the reverse order, laxative use or cleansing enema may aid in elimination of the concentrated barium.

Turnaround Time A verbal telephone report of the scan will be given to the referring physician if specified. A written report will be available.

Additional Information The patient should be informed the examination may take 30-45 minutes and that oral, rectal, and intravenous contrast media may be necessary for the examination.

References

 Scoutt LM, McCarthy SM, and Moss AA, "The Pelvis,"Computed Tomography of the Body, Moss AA, ed, Philadelphia, PA: WB Saunders Co, 1992.