CT Triphasic Liver

What the Test Reveals

• Detects the smallest liver tumors (as tiny as 5 mm)
• Maps blood supply to every corner of the liver
• Differentiates cancer from harmless cysts or hemangiomas

Why Timing Matters for Liver Health

The liver receives blood in three distinct waves. Capturing each wave separately lets radiologists spot problems early—often before symptoms appear—and plan treatment with confidence.

Definition of Triphasic Imaging

Triphasic imaging means taking three separate CT pictures of the liver at exact moments after IV contrast injection:

1. Arterial phase – highlights arteries feeding the liver
2. Portal venous phase – shows blood returning via the portal vein
3. Delayed phase – reveals wash-out patterns that separate tumors from normal tissue

How It Differs From Standard CT Scan Abdomen

Arterial Phase

Captured 20–25 seconds after contrast injection. Highlights liver cancers that prefer arterial blood.

Portal Venous Phase

Captured 60–70 seconds after injection. Shows how the liver’s main vein transports blood.

Delayed Phase

Captured 3–5 minutes after injection. Helps confirm if a lesion is cancer or a benign hemangioma.

• Liver density measurements (Hounsfield units)
• Vascular enhancement patterns in each phase
• Lesion characterization (size, borders, growth)
• Adjacent organ involvement (gallbladder, bile ducts)

• Detecting liver tumors early before they spread
• Evaluating cirrhosis progression and portal hypertension
• Pre-surgical planning for liver resection or transplant
• Monitoring known lesions for stability or growth

Symptoms That Prompt the Scan

• Unexplained right-upper-belly pain
• Sudden weight loss or appetite drop
• Jaundice (yellow skin/eyes)
• Swollen abdomen or ankles

High-Risk Groups for Liver Disease

• Chronic hepatitis B or C
• Long-term alcohol use
• Non-alcoholic fatty liver disease (NAFLD)
• Family history of liver cancer

• Precise triphasic liver imaging in under 15 minutes
• Non-invasive alternative to biopsy for many lesions
• Quick same-day results—most reports ready by evening
• Comfortable, open-bore scanner reduces claustrophobia

Fasting Guidelines

• Stop solid food 4–6 hours before scan
• Clear fluids allowed until 1 hour prior

Medication Adjustments

• Most routine medicines can continue
• Hold metformin morning of scan; resume after 48 h if kidney function normal

What to Wear

• Loose cotton clothing without metal zips or hooks
• Remove all jewelry, belts, and hairpins

• Recent kidney function tests (creatinine, eGFR within 4 weeks)
• Contrast allergy screening questionnaire
• Diabetic patients bring latest HbA1c report

• Morning slots (7 am–11 am) help maintain fasting
• Scheduling 48 hours after gadolinium MRI avoids residual contrast interference

• Adults with suspected liver pathology
• Contra-indications: pregnant women (radiation risk), severe renal failure (contrast risk)

1. Check-in & vitals
2. Change into hospital gown
3. Insert IV cannula for contrast
4. Lie on scanner table; stay still
5. Phase 1: Quick scout scan
6. Phase 2: Arterial scan post-contrast
7. Phase 3: Portal venous scan
8. Phase 4: Delayed phase
9. Total time: 10–15 minutes
10. Hydrate with 500 ml water post-scan

• Inform staff about iodine or shellfish allergies
• Hydrate well the day before to protect kidneys
• Bring a companion if you have severe anxiety

Radiation Exposure Facts

• Dose equals ~3–5 years of natural background radiation
• Our low-dose protocols cut exposure by up to 30 %

Contrast Dye Considerations

• Mild reactions (nausea, rash) in <1 % of patients
• Serious allergy risk is extremely rare
• Kidney function test required to ensure safe dye clearance