Diagnostic value of multi-slice CT for adult non traumatic acute abdomen

Objective: To investigate the value of MSCT and its reconstruction technique for etiological factors of adult non traumatic acute abdomen. Methods: The CT findings and clinical data of 1632 adult patients with non traumatic acute abdomen confirmed by clinical treatment or pathological examination from July 2007 to June 2013 were retrospectively analyzed. Six hundred and sixty-our patients underwent plain scan and 968 patients underwent plain and enhanced scan. We observed MSCT manifestations of acute abdomen, calculated the accurate rate of diagnosis, and analyzed causes of missed diagnosis or misdiagnosis. Results: CT diagnosis of 1580 cases were entirely or partially consistent with the final results in 1632 cases. Overall accuracy rate was 96.8%. Misdiagnosis or missed diagnosis accounted for 3.2% (52/1632). The corresponding accuracy rates using CT with various etiology were: urinary system stones 100.0% (293/293), appendicitis 99.3% (278/280), abdominal tumors 98.3% (227/231), cholecystitis and cholelithiasis 96.4% (213/221), acute pancreatitis 95.8% (159/166), intestinal adhesion 92.6% (100/108), gastrointestinal perforation 97.9% (92/94), internal and external hernia 95.2% (59/62), intussusceptions 95.4% (42/44), volvulus 91.7% (33/36), foreign bodies 95.6% (22/23), ectopic pregnancy 92.3% (12/13), vascular disease 100.0% (16/16), inflammatory bowel disease 77.8% (7/9), and other diseases 75.0% (27/36). The main cause of missed diagnosis was the absence of obvious morphologic changes at early stage of the diseases. Atypical MSCT features resulted in misdiagnosis. Conclusion: MSCT is a valuable tool in diagnosing adult non traumatic acute abdomen and its etiology. (authors)