CT Angiogram of the Abdomen

A CT scan of the abdomen timed to catch contrast dye while it is still filling the arteries, producing a detailed map of the aorta and the vessels branching off it. It is the standard way to look for an aneurysm, a narrowed artery, or a source of internal bleeding.

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What it is

The difference between an ordinary abdominal CT and a CT angiogram is timing. Contrast is injected into a vein in the arm, and the scanner waits for it to travel through the heart and out into the arteries, then acquires images in the seconds while those arteries are brightest. The result can be reassembled by computer into three-dimensional views of the vessel tree — the aorta running down through the abdomen, the arteries to the kidneys, liver, and intestines. Many protocols also take a set of images before the contrast goes in, which is what the "without and/or with contrast" wording covers. It is an outpatient-style test with no catheter threaded into an artery, which is what distinguishes it from conventional angiography.

Why it is done

  • To measure or follow an aneurysm — a bulge in the wall of the aorta — and to plan its repair
  • To look for a tear in the wall of the aorta
  • To find where bleeding inside the abdomen is coming from
  • To look for narrowing in the arteries feeding the kidneys or the intestine
  • To map a donor's or a recipient's vessels before abdominal surgery

What to expect

Most departments ask for several hours without food or drink beforehand, and they will ask about previous reactions to contrast, about kidney function, and about diabetes medication. A nurse places an IV, usually in the arm. The patient lies on their back on a table that slides through the scanner ring, arms overhead, holding a breath for each acquisition. When the contrast is injected by pump it commonly produces a strong warm flush through the body, a metallic taste, and a sensation like having wet oneself — all of which are expected and pass within a minute. The scanning itself is short; the whole appointment is usually under half an hour.

Questions worth asking

  • Does the price quoted include the contrast material and the IV placement, or are those separate line items?
  • Are three-dimensional reconstructions part of this study or billed as an additional service?
  • Was prior authorization obtained? CT angiography is a study insurers frequently require approval for, and a denial lands on the patient.
  • If this scan is being repeated at intervals to follow an aneurysm, can it be done at a lower-cost outpatient center rather than in the hospital?
  • Will blood work to check kidney function before the scan be billed separately?

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