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Abstract
Beccause of high frequency of focal liver lesions characterisation of these lesions is essential. Consequently, the preferred CT technique for liver examination should combine a high sensitivity for lesion characterisation, to differentiate lesions that do need further diagnostic tests or treatment from lesions that do not.
Helical CT of the liver consistently results in high quality scans as a result of the ability to image the liver in a single breath hold. Lesion detection is aided by scanning during the peak hepatic enhancement, lack of respiratory misregistrations, and by obtaining overlapping axial reconstructions.
Because of these advantages, helical CT of the liver is the preferred scanning mode for evaluation of hepatic disease.
This study was performed on 107 patients, 76 males; whose ages ranged from 11 to 78 years (mean age: 44.5 y ) and 40 females whose ages ranged from 19 to 75 years ( mean age: 47y).
They were referred from the different medical and surgical departments as well as out patient clinics of Menufiya University Hospital for examination of the liver with triphasic CT protocol by spiral CT scanner.
Triphasic spiral CT is a standarized CT procedure that allows imaging of the entire liver in arterial, portal, and equilibrium phases.
The portal phase images acquired at the peak hepatic enhancement are the centerpiece of the protocol and are essential for lesion detection, being the most sensitive phase.
Arterial phase images are helpful in the detection of hypervascular lesions and are essentional for the characterization of a large proportion of lesions.
Equilibrium phase images further aid in lesion characterization. Both the arterial and equilibrium phases can supply information on the vascularity of lesions that may help to clarify its nature.
In clinical practice, one has to decide when to use triphasic liver CT.
The liver is scanned three times, with resultant increased radiation exposure. In addition, the procedure takes more time and is more costly than single-phase spiral CT.
Therefor, one has to limit its use to patients who are likely to gain from this additional burden.
Patients with unclassified lesions at ultrasound or monophasic CT , patients with chronic liver disease with the possibility of HCC, patients with a known primary hypervascular tumour, and patients with possible resectable liver metastases constitute the vast majority of those who will gain benefit from the triphasic liver CT.
Thus, we recommend the technique for these patients who will gain the utmost benefit from it.