Radiographic anatomy

Anterior abdominal wall

Plain film radiography (Fig. 9.1) is not used to evaluate the anterior abdominal wall.

Peritoneum

Plain radiography (Fig. 9.1) has been superseded by cross-sectional imaging techniques and the peritoneal cavity is visualized only via contrast herniography (Fig. 9.2).

Cross-sectional anatomy

Cross-sectional imaging techniques optimally assess the anterior abdominal wall and peritoneum.

Anterior abdominal wall

US

Ultrasound is useful in evaluating focal masses in the anterior abdominal wall but does not demonstrate the anatomical relations as well as computed tomography (CT) or magnetic resonance imaging (MRI).

CT/MRI

CT and MRI provide excellent anatomical detail of the anterior abdominal wall in the axial plane.

MRI has superior soft-tissue contrast resolution but images can be degraded by respiratory artefact.

Peritoneum

US

Ultrasound is widely used to detect intraperitoneal collections, but is limited by bowel gas and body habitus.

CT/MRI

Contrast-enhanced CT (with or without oral contrast medium) is the method of choice to evaluate the peritoneal spaces, reflections and their contents.

MRI provides good visualization of the peritoneal spaces and reflections; however, bowel peristalsis and respiratory movement can degrade the images.