From the Guidelines
The most commonly used test for diagnosing an abdominal mass is imaging, with options including ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI).
Diagnostic Tests
- Ultrasound (US) is often used as the initial imaging modality of choice when a pulsatile abdominal mass is present, as it is non-invasive and can provide valuable information about the size and location of the mass 1.
- CT scans can provide more detailed information about the mass, including its size, shape, and relationship to surrounding structures, and can be used to guide further treatment 1.
- MRI can also be used to evaluate abdominal masses, particularly in patients who cannot undergo CT scans or who require more detailed imaging 1.
Choosing a Diagnostic Test
The choice of diagnostic test will depend on the specific clinical presentation and the suspected cause of the abdominal mass.
- For example, if an abdominal aortic aneurysm (AAA) is suspected, a CT scan with intravenous contrast may be the best initial test, as it can provide detailed information about the size and location of the aneurysm 1.
- If a subepithelial gastric mass is suspected, endoscopic ultrasonography (EUS) may be the best initial test, as it can provide detailed information about the size and location of the mass, as well as its relationship to surrounding structures 1.
From the Research
Diagnostic Tests for Abdominal Masses
- Abdominal CT scans are used to diagnose abdominal masses, particularly in cases where the mass is accompanied by abscess and rupture 2
- Ultrasound is also used to evaluate palpable abdominal masses, with a high accuracy rate of 96% in verifying the presence of a mass and 91% in determining the correct origin of the mass 3
- Imaging modalities such as CT scans and ultrasound play a crucial role in characterizing abdominal masses, staging the extent of disease, and assisting in presurgical planning, especially in pediatric cases 4
- A diagnostic algorithm that combines clinical history and imaging appearances can help classify lesions and distinguish between different types of abdominal wall masses 5, 6
Imaging Features and Characteristics
- Imaging features such as the composition of the mass (fat-containing, cystic, or solid) can help narrow down the differential diagnosis 6
- The most common fat-containing masses are lipomas, while fluid or cystic masses include postoperative abscesses, seromas, and rectus sheath hematomas 6
- Solid masses are the most common abdominal wall masses and include desmoid tumors, sarcomas, endometriomas, and metastases 6
Diagnostic Approach
- A diagnostic approach that combines clinical history and imaging appearances can help accurately diagnose abdominal wall masses 5, 6
- In cases where a discrete mass is confirmed to be present, the next step is to determine its composition and characteristics 6
- Imaging guidelines and recommendations can help establish a practical imaging algorithm for suspected pediatric abdominal masses 4