Patient History

A 78 year old female patient presented with abdominal pain and tenderness with a history of change in bowel habit months prior to admission.
On examination she was tachycardic, with signs of an acute abdomen.
The suspected clinical diagnosis was acute diverticulitis or a perforated carcinoma.

Procedure

Exam performed on a LightSpeed Plus scanner (4 slice system); see acquisition parameters below the radiological findings.

CT Perfusion Findings

The portal venous phase diagnostic scan shows multiple loculated intra-abdominal collections secondary to acute diverticulitis, complicated by perforation (Figure 1); this was confirmed at surgery.

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(Figure 1)

Contrast enhanced scan showing acute diverticulitis with multiple pericolic abscesses

Perfusion maps showing blood volume, blood flow, mean transit time and permeability (Figure 2) are typical of an acute inflammatory process.
In difficult cases perfusion measurements will provide functional information, aiding differentiation between diverticular disease and cancer.

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(Figure 2)

Blood volume map	Blood Flow map
Mean transit time map	Permeability map

Blood volume, blood flow, mean transit time and permeability maps of the diverticular segment show acute inflammation.

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Acquisition Parameters

• Acquisition time: 60s
• Rotation speed: 1s
• Collimation: 4 x 5 mm
• Scan delay: 5 seconds
• Tube voltage: 120 kV
• Tube current: AutoMa 80 mA
• Contrast agent: 350 Omnipaque - 100 cc at 5ml/s