Contrast Is Unnecessary for Most Abdominal CTs
Emergency Physicians Monthy - by Richard Bukata, MD on June 10, 2013
Emergency Physicians Monthy - by Richard Bukata, MD on June 10, 2013
A growing body of research flies in the face of this common radiology practice
"The routine use of contrast (both oral and IV, and certainly rectal) is unnecessary for the majority of abdominal CT scans performed in the ED. At least that is what the literature says over and over.
Unfortunately, many radiologists disagree. Is their objection based on a sound analysis of the literature? Hardly. In most cases it is a matter of personal preference. They have been using contrast since their residency, or at least since CTs came on the scene, and just feel more comfortable with it. Have they made an honest effort to compare results with and without contrast ? Probably not. Do they care that oral contrast will add about two hours to an ED stay and, even when given, frequently doesn’t get to the cecum? Probably not.
But when the use of contrast is subject to the intense searchlight of scientific inquiry, the answer seems to be pretty clear. It is the atypical patient with nontraumatic abdominal pain who needs contrast."
Unfortunately, many radiologists disagree. Is their objection based on a sound analysis of the literature? Hardly. In most cases it is a matter of personal preference. They have been using contrast since their residency, or at least since CTs came on the scene, and just feel more comfortable with it. Have they made an honest effort to compare results with and without contrast ? Probably not. Do they care that oral contrast will add about two hours to an ED stay and, even when given, frequently doesn’t get to the cecum? Probably not.
But when the use of contrast is subject to the intense searchlight of scientific inquiry, the answer seems to be pretty clear. It is the atypical patient with nontraumatic abdominal pain who needs contrast."
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