CT TRIPHASIC SCAN (DELDC) at Dr. Essa Lab

CT TRIPHASIC SCAN (DELDC) at Dr. Essa Lab

The CT TRIPHASIC SCAN (DELDC) at Dr. Essa Lab is a highly specialized, state-of-the-art diagnostic imaging procedure designed to evaluate abdominal organs, particularly the liver, pancreas, and kidneys, with exceptional precision. Unlike standard computed tomography scans, a triphasic CT scan captures images at three distinct phases of contrast enhancement: the arterial phase, the portal venous phase, and the delayed (or equilibrium) phase. This multi-phase imaging technique is crucial for detecting, characterizing, and differentiating complex lesions, tumors, and vascular abnormalities that might otherwise remain invisible or indeterminate on routine scans.

By utilizing advanced multi-slice CT technology at Dr. Essa Lab in Karachi, Pakistan, this examination provides high-resolution cross-sectional images. The physiological basis of the triphasic scan lies in the dual blood supply of the liver. While normal liver tissue receives about 75% of its blood from the portal vein and only 25% from the hepatic artery, primary liver tumors like hepatocellular carcinoma (HCC) receive almost 100% of their blood supply from the hepatic artery. By capturing images at precise time intervals after the injection of an iodinated contrast medium, radiologists can observe how contrast flows into, through, and out of lesions, allowing for highly accurate diagnoses.

The diagnostic value of this scan is unparalleled in modern abdominal oncology and hepatology. It allows for the early detection of hypervascular tumors, characterization of benign lesions such as hemangiomas and focal nodular hyperplasia (FNH), and detailed mapping of vascular anatomy prior to complex surgical interventions or liver transplantation. Patients benefit from rapid scanning times, highly detailed anatomical visualization, and the clinical expertise of consultant radiologists at Dr. Essa Lab, ensuring a reliable pathway toward effective treatment planning.

Clinical Procedure: What to Expect

Patient Preparation

Proper patient preparation is essential to ensure diagnostic accuracy and patient safety during a CT TRIPHASIC SCAN (DELDC) at Dr. Essa Lab. Patients are advised to adhere to the following guidelines:

• Fasting: Patients must fast (no solid food or liquids other than water) for at least 4 to 6 hours prior to the scheduled scan to ensure the stomach and bowel are empty.
• Kidney Function Test: Since the procedure requires the administration of intravenous iodinated contrast, a recent Serum Creatinine test (usually within the last 30 days) is mandatory to assess renal function.
• Allergy History: Patients must inform the medical staff of any history of allergies, particularly to iodine, contrast media, or shellfish.
• Medication Review: Patients taking metformin for diabetes may need to temporarily discontinue the medication for 48 hours after the scan, under the guidance of their physician.
• Hydration: Adequate hydration before and after the procedure is highly recommended to help the kidneys flush out the contrast medium.
• Clothing: Wear loose, comfortable clothing. Avoid wearing jewelry, metallic objects, or clothing with metal zippers, as these can interfere with the imaging process.

During the Procedure

Upon arrival at Dr. Essa Lab, the patient will be guided through the imaging process by a trained radiologic technologist. The step-by-step procedure includes:

• IV Cannulation: A small intravenous (IV) catheter is placed in a vein, typically in the arm, to facilitate the rapid injection of the contrast dye.
• Patient Positioning: The patient lies flat on their back on the motorized CT scanner table, which slides smoothly into the circular opening of the gantry.
• Contrast Administration: An automated power injector is connected to the IV line. As the contrast is injected, patients may experience a temporary warm sensation throughout their body, a metallic taste in the mouth, or the sensation of needing to urinate. These are normal and transient side effects.
• Multi-Phase Scanning: The scanner will capture images at three precise intervals: the arterial phase (approx. 25–35 seconds post-injection), the portal venous phase (approx. 60–70 seconds post-injection), and the delayed phase (approx. 3–5 minutes post-injection).
• Breath-Holding: The patient will be instructed to hold their breath for a few seconds during each scanning phase to eliminate motion blur.
• Duration: The actual scanning process takes less than 10 minutes, although the entire visit may take 30 to 45 minutes including preparation and post-procedure monitoring.

When is a CT TRIPHASIC SCAN (DELDC) Performed?

Suspected Hepatocellular Carcinoma (HCC)

Physicians frequently request a triphasic CT scan for patients with chronic liver diseases, such as Hepatitis B, Hepatitis C, or liver cirrhosis, who present with elevated Alpha-Fetoprotein (AFP) levels. The scan is highly effective at identifying the classic enhancement pattern of HCC, which includes rapid contrast uptake (wash-in) during the arterial phase followed by rapid clearing (washout) during the portal venous and delayed phases.

Characterization of Indeterminate Liver Masses

When routine abdominal ultrasounds or standard CT scans reveal an ambiguous liver lesion, a triphasic scan is ordered to differentiate between benign conditions (such as hepatic hemangiomas, focal nodular hyperplasia, or adenomas) and malignant tumors (such as cholangiocarcinoma or metastatic disease). This prevents unnecessary invasive biopsies for benign lesions.

Pre-operative Surgical Planning and Liver Mapping

Before major liver resections, tumor ablations, or liver transplantation, surgeons require a detailed map of the patient’s hepatic vasculature and segmental anatomy. The CT TRIPHASIC SCAN (DELDC) provides precise three-dimensional visualization of the hepatic arteries, portal veins, and hepatic veins, ensuring surgical safety and efficacy.

Evaluation of Pancreatic and Renal Pathologies

Although primarily used for liver imaging, the triphasic protocol is highly valuable for evaluating hypervascular pancreatic neuroendocrine tumors, pancreatic adenocarcinoma, and renal cell carcinomas. It helps determine the extent of local invasion, vascular involvement, and distant staging.

Monitoring Therapeutic Response

For patients undergoing localized liver cancer treatments, such as Transarterial Chemoembolization (TACE), Radiofrequency Ablation (RFA), or systemic chemotherapy, the triphasic scan is performed at regular intervals to assess the reduction in tumor vascularity and detect any signs of local recurrence or new lesion development.

What Does a CT TRIPHASIC SCAN (DELDC) Detect?

The CT TRIPHASIC SCAN (DELDC) is capable of detecting a wide range of complex abdominal conditions, including:

• Hepatocellular Carcinoma (HCC) with characteristic arterial enhancement and venous washout.
• Hepatic Hemangiomas showing progressive peripheral nodular enhancement.
• Focal Nodular Hyperplasia (FNH) with a central scar and rapid arterial enhancement.
• Hepatic Adenomas, which carry a risk of hemorrhage and malignant transformation.
• Hypervascular and hypovascular liver metastases from primary extrahepatic cancers.
• Cholangiocarcinoma (bile duct cancer) showing delayed enhancement.
• Portal Vein Thrombosis, differentiating bland thrombus from tumor thrombus.
• Budd-Chiari Syndrome and hepatic venous outflow obstruction.
• Liver Cirrhosis, including morphological changes, nodularity, and portal hypertension.
• Hepatic Steatosis (fatty liver disease) and focal fat sparing.
• Pancreatic Adenocarcinoma and its relationship with surrounding major vessels.
• Pancreatic Neuroendocrine Tumors (pNETs) showing intense arterial enhancement.
• Renal Cell Carcinoma (RCC) and associated renal vein invasion.
• Splenomegaly and splenic infarcts or lesions.
• Abdominal Aortic Aneurysms and vascular malformations.
• Abdominal Lymphadenopathy (enlarged lymph nodes) indicating metastasis or lymphoma.
• Ascites (fluid accumulation in the peritoneal cavity).
• Biliary tract dilatation and obstruction.
• Adrenal adenomas and metastatic adrenal lesions.
• Collateral vascular pathways resulting from portal hypertension.

Turnaround Time and Report Access at Dr. Essa Lab

At Dr. Essa Lab, we prioritize both accuracy and efficiency in delivering diagnostic results. Once the CT TRIPHASIC SCAN (DELDC) is completed, the extensive dataset of cross-sectional images is processed and reconstructed by advanced software. A consultant radiologist specializing in abdominal imaging meticulously reviews all three phases of the scan, comparing enhancement patterns and evaluating adjacent anatomical structures.

The finalized, comprehensive diagnostic report is typically available within 24 to 48 hours. Patients and referring physicians can easily access the digital reports and high-resolution imaging scans online through the official Dr. Essa Lab web portal or mobile application. Physical copies of the report and imaging films can also be collected directly from the diagnostic center where the scan was performed.

CT TRIPHASIC SCAN (DELDC) Findings Overview

Structure / Parameter Evaluated	Normal Findings	Possible Abnormal Findings
Hepatic Parenchyma	Homogeneous enhancement across all phases; no focal lesions.	Hypervascular masses (HCC), hypodense cysts, hemangiomas, or metastatic lesions.
Portal Vein	Patent lumen with normal hepatopetal flow; no filling defects.	Portal vein thrombosis, tumor invasion, or cavernous transformation.
Hepatic Arteries	Normal anatomical branching and caliber; no aneurysms.	Arterial stenosis, aneurysms, or abnormal neovascularization feeding a tumor.
Biliary Tree	No intrahepatic or extrahepatic biliary ductal dilatation.	Choledocholithiasis, biliary strictures, or cholangiocarcinoma.
Pancreas	Normal size, lobulated architecture, and uniform enhancement.	Pancreatic ductal adenocarcinoma, neuroendocrine tumors, or pseudocysts.
Spleen	Normal size (under 12 cm) and homogeneous enhancement.	Splenomegaly, splenic infarcts, or varices at the splenic hilum.
Kidneys & Adrenals	Symmetrical excretion of contrast; normal adrenal morphology.	Renal cell carcinoma, renal cysts, or adrenal adenomas.
Peritoneal Cavity	No free fluid, air, or pathological peritoneal thickening.	Ascites, peritoneal carcinomatosis, or loculated fluid collections.

Note: Diagnostic findings should always be interpreted by a qualified healthcare professional together with the patient’s symptoms, medical history, physical examination, laboratory investigations, previous imaging studies, and other relevant clinical information. Additional investigations or specialist consultation may be recommended depending on the findings.

Why Choose Dr. Essa Lab for CT TRIPHASIC SCAN (DELDC)?

• Decades of Trust: Dr. Essa Lab is one of Pakistan’s most respected diagnostic networks, serving patients since 1987.
• Advanced Multi-Slice CT Technology: Equipped with modern CT scanners that deliver high-resolution imaging with minimized radiation dose.
• Expert Radiologists: Scans are interpreted by highly qualified consultant radiologists with specialized training in abdominal and oncological imaging.
• Rigorous Contrast Safety: Strict pre-scan screening protocols, including mandatory renal function checks, to ensure patient safety.
• ISO Certified Standards: Adherence to international quality management systems to guarantee diagnostic accuracy.
• Convenient Online Reports: Seamless digital access to reports and images via the Dr. Essa Lab website and mobile app.
• Extensive Branch Network: Multiple convenient locations across Karachi and other major cities for easy accessibility.
• Compassionate Patient Care: Dedicated staff providing a supportive, comfortable, and professional environment throughout your diagnostic journey.