How Accurate Are Unenhanced CT Scans for Evaluating Acute Abdominal Pain?

Intravenous contrast-enhanced computed tomography (CT) is the imaging procedure of choice for evaluating patients with acute abdominal pain, but clinicians sometimes consider withholding intravenous contrast due to concerns about renal toxicity or hypersensitivity. Investigators used a novel technique to compare the diagnostic accuracy of unenhanced CT scans with contrast-enhanced scans by digitally subtracting the contrast effect. Six radiologists interpreted the unenhanced versions of the scans, and their diagnostic findings were compared with consensus interpretation of the contrast-enhanced versions by other radiologists.

A total of 201 consecutive contrast-enhanced CT scans ordered for acute abdominal pain at a single U.S. institution w…