How to read CT of the abdomen and pelvis

Annotated teaching case

CLICK HERE to view this case in FULL SCREEN mode (in Radiopaedia).

CLICK HERE to view the unlabeled case as a DICOM (in Pacsbin)

Introductory lectures

Introduction to Abdominal CT

Helpful lecture highlighting the role of abdominal CT, the different types of exams, and the basics of search pattern and reporting.

Abdominal planes on CT

Ordering the right study

Evaluating the liver

Evaluating the arteries

I created these mini-lectures with Medmastery as part of a comprehensive abdominal CT course. They are only 3-5 minutes long but very high-yield.

I encourage you to check out my Medmastery courses which covers all important aspects of reading of abdominal CT!

How to use a basic PACS viewer

Pull up a CT and review it like a pro!

This quick video that reviews how to properly manipulate radiology images that every student and trainee should be familiar with. This includes changing window/level settings, basic annotation, measuring ROI, and changing the layout to triangulate a finding in two planes.

Understanding window, level and HU

This "adjusting window settings" Medmastery lecture will demystify an often confusing concept for learners and radiologists alike and explain what exactly the window/level settings mean.

Put your skills into practice!

After watching these mini-lectures I created with Medmastery, practice diagnosing appendicitis, diverticulitis, and SBO on a real PACS viewer with annotated DICOM teaching cases!

Mini-lecture 1: Acute appendicitis

Case 1: Acute appendicitis

Case 2: Peforated appendicitis

Mini-lecture 2: Diverticulitis

Case 1: Sigmoid diverticulitis

Case 2: Perforated diverticulitis

Mini-lecture 3: SBO

Case 1: SBO - adhesions

Case 2: SBO - hernia

Search pattern essentials


Self-guided review of anatomy

The radiologists job starts with understanding what basic anatomy looks like on x-ray, CT, MRI, US and nuclear medicine scans. I often find it amazing how much of my job is simply being aware of normal anatomic relationships and structures in imaging, the same basics that are taught in anatomy through Netter diagrams and cadaveric dissections. Deviations from normal form the basis by which radiologists identify, describe, and understand disease.

Thus, the importance of identifying these normal structures cannot be overstated! Take your time and build the mental connections that bridge your varied experiences with illustrations, cadaver experiences, and cross-sectional imaging (in this case, CT) into a rich, 3-dimensional understanding of anatomy that will benefit your medical studies greatly!

How to read a CT of the abdomen and pelvis (axial)

Review key anatomy and learn the basic search pattern that radiogists use to review every CT exam.

The axial plane is the view that most radiologists use to primarily interpret studies.

How to read a CT of the abdomen and pelvis (coronal)

The coronal plane is more intuitive to look at for many beginners and non-radiologists. It can be thought of as "looking at the patient in front of you". This view also provides a "second chance" to identify important findings that may be easy to overlook in the axial plane.

Routinely reviewing both axial and coronal planes will help your brain form a 3-dimensional understanding of anatomy.

CT abdomen and pelvis template checklist.docx

Supplemental: Reporting template

This is the template I use to interprate all of my CT of the Abdomen and Pelvis exams.

This checklists serve as a guide to help you develop your search pattern, and draws attention to pertinent positives and negatives for each organ system. Example normal language that could be used in the final report is italicized.

This is a great resource to have printed or on a laptop/tablet during abdominal radiology rotations, or for attempting to interpret studies on your own!

Next step: Abdominal CT 101

Reinforce what you have learned and take your skills to the next level by reading real CTs in a web-based PACS viewer in Abdominal CT 101!