Intravenous contrast in CT scans for undifferentiated abdominal pain may not be needed

Omitting intravenous contrast in abdominal computed tomography (CT) scans for undifferentiated abdominal pain did not result in a significant difference in the rate of diagnostic uncertainty, according to a study.

The study, conducted at a single center emergency department, retrospectively analyzed data from patients presenting with undifferentiated abdominal pain prior to and during a contrast shortage in June 2022. The primary outcome measured was the rate of diagnostic uncertainty, indicating cases where the presence or absence of intra-abdominal pathology could not be determined.

The results revealed that among the unenhanced abdominal CT scans (without intravenous contrast), 12 out of 85 (14.1%) provided uncertain results. In comparison, among the control cases performed with intravenous contrast, 14 out of 101 (13.9%) showed diagnostic uncertainty. Statistical analysis demonstrated no significant difference in the rate of uncertain findings between the two groups. Furthermore, both groups had similar rates of positive and negative findings.

Reference
Narita C, Clements W, Varma D. Assessing the necessity of intravenous contrast for computed tomography in the acute undifferentiated abdomen. J Med Imaging Radiat Oncol. 2023;doi: 10.1111/1754-9485.13559. Epub ahead of print. PMID: 37403895.