TRIPHASE CT ABDOMEN

### Arterial Phase This first set of images is taken shortly after the contrast injection when the material is most concentrated in your arteries. This phase is excellent for visualizing organs with a rich arterial blood supply and identifying certain types of tumors that receive blood from arteries. ### Venous Phase (or Portal Venous Phase) This second set of images is captured a bit later, as the contrast material moves out of the arteries and into the veins. This phase provides the clearest view of organs like the liver and spleen. ### Delayed/Equilibrium Phase The final set of images is taken a few minutes later. In this phase, the contrast material has had time to wash out of the vessels and seep into the tissue of organs. This can help characterize certain lesions, as some tumors retain the dye longer or wash it out faster than normal tissue. ## Types of Triphase CT Scan ### Focused Liver Protocol The timing of the phases is optimized specifically to characterize different types of liver lesions, such as cysts, hemangiomas, or cancerous tumors. ### Pancreatic Protocol This protocol uses specific timing and thin image slices to get the best possible view of the pancreas, which is essential for detecting and staging pancreatic tumors. ### Renal Mass Protocol The phases are timed to evaluate blood flow to and from a kidney mass, which helps differentiate between benign cysts and potentially cancerous tumors.

• Organ Structure & Size: The size, shape, contour, and density of the solid abdominal organs—including the liver, pancreas, spleen, kidneys, and adrenal glands—are carefully evaluated for any abnormalities.
• Vascular Anatomy: The major abdominal blood vessels, such as the aorta, inferior vena cava, and portal vein, are assessed for blockages, aneurysms, or other abnormalities.
• Lesion Characterization: This is the cornerstone of a Triphase CT Abdomen. The radiologist analyses how any detected mass or lesion enhances (brightens) with the contrast dye across the arterial, venous, and delayed phases. This enhancement pattern is a key indicator that helps differentiate benign (non-cancerous) from malignant (cancerous) conditions.
• Signs of Inflammation or Infection: The scan can clearly show signs of conditions like pancreatitis (inflammation of the pancreas), cholecystitis (inflammation of the gallbladder), or abscesses (collections of pus).
• Surrounding Tissues: The scan also provides a clear view of the surrounding soft tissues, lymph nodes, and bowel loops.

• To fully characterize a liver mass that was found on a different imaging scan, like an ultrasound.
• To diagnose, stage, and monitor suspected liver cancer (Hepatocellular Carcinoma - HCC). This is a primary use for a triple phase CT for liver.
• To evaluate and stage suspected pancreatic tumors.
• To investigate certain types of kidney masses to determine if they are cancerous.
• To assess significant trauma to abdominal organs after an accident.
• For pre-surgical planning before a major operation on the liver, pancreas, or kidneys.
• To look for the source of bleeding within the abdomen.

When and Who Needs to Take a Triphase CT Abdomen?

Common Indications

• Unexplained abdominal pain or discomfort.
• Abnormal results from blood tests, particularly liver function tests.
• Jaundice (yellowing of the skin and eyes).
• Suspicion of a mass or tumor in the abdomen.

Benefits of Taking the Test

• High Diagnostic Accuracy: This scan provides exceptionally clear and detailed images, allowing for a very precise and confident diagnosis of many abdominal conditions.
• Problem-Solving Tool: It is often the key to solving diagnostic puzzles, helping to clarify ambiguous or confusing findings from other tests like ultrasounds or blood work.
• Guides Treatment: The information gathered is critical for your medical team. It helps surgeons plan complex procedures, and it guides oncologists in choosing the most effective chemotherapy or radiation therapy.
• Non-Invasive: Apart from the IV injection, the procedure is non-invasive and provides a detailed view of the abdomen without the need for exploratory surgery.
• Monitors Conditions: For patients with known tumors, the scan can be used over time to track the size of the tumor and see how it is responding to treatment.

Illness Diagnosed with Triphase CT Abdomen

• Liver Tumors: Both malignant tumors like Hepatocellular Carcinoma (HCC) and metastatic disease (cancer that has spread to the liver), as well as benign tumors like hemangiomas, focal nodular hyperplasia (FNH), and adenomas.
• Pancreatic Conditions: Pancreatic cancer, neuroendocrine tumors, and both acute and chronic pancreatitis.
• Kidney Tumors: Including Renal Cell Carcinoma (RCC) and benign masses like angiomyolipomas.
• Adrenal Gland Tumors: Such as adenomas or pheochromocytomas.
• Vascular Abnormalities: Including aortic aneurysms, blood clots, and active internal bleeding.

Diet

You will likely be asked to fast for 4 to 6 hours before your appointment. This means no solid food, and often only clear liquids are allowed. An empty stomach prevents nausea and ensures the images of your digestive tract are clear.

Clothing

On the day of your scan, wear comfortable, loose-fitting clothing. Avoid clothes with metal zippers, snaps, buckles, or underwire bras, as metal can interfere with the CT images. You may be asked to change into a medical gown provided by us.

Medication

Please inform our staff at Cadabams Diagnostics about all the medications you are currently taking. It is especially important to tell us if you are taking Metformin (also known as Glucophage) for diabetes, as you may be instructed to stop taking it for a short period before and after your scan.

Allergies & Health Conditions

Make sure to inform the booking staff and the technologist about any known allergies (especially to iodine or previous contrast dyes), kidney problems, or if there is any chance you might be pregnant.

Pre-requisites

• A doctor's referral/prescription is required to undergo a Triphase CT Abdomen.
• Depending on your age and medical history, you may be asked to provide recent kidney function test results (specifically Creatinine and eGFR). This is a safety measure to ensure your kidneys can safely process the contrast dye.

Best Time to Take the Triphase CT Abdomen

Unlike some blood tests that require a specific time of day, this scan is not time-sensitive. It can be scheduled at any time during our operational hours based on your convenience and the availability of appointments at Cadabams Diagnostics.

Eligibility

Absolute Contraindications

• Pregnancy: The test is generally avoided in pregnant patients unless it is a life-threatening emergency.
• Severe Contrast Allergy: If you have had a severe, life-threatening reaction to iodine-based contrast dye in the past, this test may not be for you.

Relative Contraindications (require discussion with your doctor)

• Poor Kidney Function: Will require careful consideration and may need pre-procedure hydration.
• Breastfeeding: The contrast agent can pass into breast milk in very small amounts. You may be advised to pump and discard your breast milk for 24 hours after the scan. Please discuss this with our staff.

Procedure for Taking a Triphase CT Abdomen

Check-in & Preparation

You will register at our front desk, where our staff will verify your information and doctor's referral. You may be asked to fill out a safety questionnaire. Afterwards, you will be guided to a changing area to put on a hospital gown if needed.

IV Line Placement

A trained technologist or nurse will place a small, thin plastic tube (an IV cannula) into a vein in your arm or hand. This is used to administer the contrast dye during the scan. You will feel a small prick, similar to giving a blood sample.

Positioning

You will be asked to lie down on your back on a motorized scanning table. The technologist will ensure you are comfortable and positioned correctly. The table will then slide slowly into the large, donut-shaped opening of the CT scanner. Your head will remain outside the scanner.

Initial Scan (Non-Contrast)

In some cases, a quick scan may be performed before the contrast is given. This provides a baseline set of images.

Contrast Injection

The technologist, operating from an adjacent control room, will start the injection of the contrast dye through your IV line using an automated injector pump. As the dye enters your bloodstream, it is very common to feel a warm sensation spreading through your body and a temporary metallic taste in your mouth. This is a normal reaction and passes within a minute or two.

Phased Scanning

This is the core of the procedure. The CT scanner will rapidly acquire the three sets of images at the precise arterial, venous, and delayed timings. The technologist will communicate with you through an intercom and instruct you when to hold your breath for about 10-15 seconds at a time. It is very important to remain perfectly still during this process.

Completion

The entire time spent in the scanner room is typically about 15-30 minutes. Once all the images have been captured, the technologist will slide the table out of the scanner and remove your IV line.

Caution Before Taking the Test

For your safety, it is crucial that you share the following information with our staff before your scan begins:

• If there is any possibility you could be pregnant.
• If you have any known allergies, especially to medications, iodine, shellfish, or a previous CT contrast dye.
• If you have diabetes and are taking Metformin.
• If you have a history of kidney disease, kidney failure, or kidney surgery.
• If you are currently breastfeeding.
• If you have asthma or any other significant medical conditions.