TRIPHASIC CT Scan A radiological approach.pptx

Triphasic CT Scan

1. 1

2. 2 PRESENTER DR Nazish Fatima Registrar Diagnostic Radiology SUPERVISOR Lt Col Huma Hameed HOD Radiology Classified Radiologist Combined Military Hospital Malir

3. Objective To highlight the role of TRIPHASIC CT scan in characterization of hepatic lesions. 3

4. Objective Cases Presentation Case Discussion Literature Review Conclusion 4 Sequence

5. Case - 1 Presentation

6. Patient Profile 6 XYZ 46 years Hyderabad Name Hospital CMH Malir Presented 1 1-09-2025

7. 7 ULTRASOUND

8. TRI-PHASIC CT ABDOMEN 8 Pre contrast assessment Asked H/O IV contrast allergy Known drug allergy Informed Written Consent

9. 9 TRIPHASIC CT ABDOMEN

10. 10 ULTRASOUND

11. 11 TRIPHASIC CT ABDOMEN HEPATIC AVM

12. Case -2 Presentation

13. Patient Profile XYZ 35 years Karachi Name Hospital CMH Malir Presented 22-01-2025 13

14. Presenting Complaints 14 3 - 4 days Dyspepsia bloating 3 - 4 days

15. 15 ULTRASOUND

16. 16 TRIPHASIC CT ABDOMEN

17. TRIPHASIC CT ABDOMEN 17 HEPATIC HEMANGIOMA

18. Case -3 Presentation

19. Patient Profile XYZ 65 years Malir Name Hospital CMH Malir Presented 01-09-2025 19

20. Presenting Complaints 20 3 – 4 months Lethargy Weight loss

21. 21 ULTRASOUND

22. TRIPHASIC CT ABDOMEN 22

23. 23 TRIPHASIC CT ABDOMEN

24. TRIPHASIC CT ABDOMEN 24 HEPATOCELLULAR CARCINOMA

25. Case Discussion 25

26. TRI-PHASIC CT ABDOMEN FOR CHARACTERIZATION HEPATIC LESIONS

27. TRIPHASIC CT SCAN

28. TRIPHASIC CT SCAN

29. TRIPHASIC CT SCAN

30. TRIPHASIC CT SCAN

31. 31 Principal of contrast enhancement

32. TRIPHASIC CT SCAN

33. 33 TRIPHASIC CYCLE

34. 34 PATHOPHYSIOLOGY OF HEPATIC TUMORS

35. TRIPHASIC CT SCAN Lesions with Poor blood supply Lesions with rich blood supply

36. INDICATIONS

37. CONTRA-INDICATIONS

38. PRE – CONTRAST PREPERATION

39. 39 Pre contrast assessment Asked H/O IV contrast allergy Known drug allergy Pregnancy / Lactation Thyroid abnormalities Using any medications WRITTEN CONSENT

40. Preparation

41. INVESTIGATION

42. CONTRAST

43. TECHNIQUE

44. TECHNIQUE

45. PHASES OF TRIPHASIC CT ABDOMEN

46. In arterial phase hypervascular lesions enhance via hepatic artery. While normal liver parenchyma yet not enhance because the contrast has not reach the Portovenous system. So the lesions appear hyperdens in a relatively hypodense liver. When the surrounding liver parenchyma starts to enhance on Portovenous phase these hypervascular lesions become obscured. ARTERIAL PHASE

47. ARTERIAL PHASE

48. In Portovenous phase hypovascular lesions are detected when normal liver parenchyma enhance maximally. These hypovascular lesions appear hypodense in a relatively hyperdens liver. PORTOVENOUS PHASE

49. PORTOVENOUS PHASE

50. In delayed phase tumors are visible that either loose their contrast slower than normal liver parenchyma or wash out their contrast faster than normal liver parenchyma. These tumors will become either relatively hyperdens or hypodense to the normal liver parenchyma. DELAYED PHASE

51. DELAYED PHASE

52. HYPERVASCULAR LESIONS

53. HCC Hemangioma AVM HYPERVASCULAR LESIONS

54. LITERATURE REVIEW

55. LITERATURE REVIEW August 2025 - September 2025

56. 56 Triphasic CT abdomen 30 -35 mSv X-ray chest 0.1 mSv Plain CT head 2 mSv Hrct chest 0.9 mSv TRIPHASIC CT SCAN

57. Triphasic CT scan play a vital role in characterizing hepatic SOLs by providing valuable information on their enhancement pattern and vascularity. This enables radiologist to differentiate between benign and malignant lesions, identify specific tumor types and minimizing need of biopsy . CONCLUSION

58. The benefits of Triphasic CT scan abdomen in diagnosing and managing hepatic lesions must be balanced against the risk associated with radiation exposure. TAKE HOME MESSAGE

59. 59

60. INTERACTIVE SESSION 60

61. How many phases of Triphasic CT abdomen? INTERACTIVE SESSION

62. Blood supply of liver? INTERACTIVE SESSION

63. Which lesions appear bright on arterial phase? INTERACTIVE SESSION

64. What are the pre requirements of Triphasic CT? INTERACTIVE SESSION

65. Radiation dose during Triphasic CT abdomen?