Gall Bladder cancer Surgical planning on CT scan- Triphasic CT liver protocol - Correlate clinically
A triphasic CT liver protocol is a specialized imaging technique used to evaluate the liver and its blood vessels in multiple phases. It provides detailed information about the liver's arterial, portal venous, and delayed phases, allowing for better visualization and characterization of liver lesions, vascular abnormalities, and other liver conditions. Here's a general overview of the triphasic CT liver protocol:
Arterial phase: The arterial phase is the first phase of the CT scan. It is timed to capture the peak arterial enhancement of the liver. A contrast agent is injected intravenously, and images are acquired as the contrast flows through the arteries supplying the liver. This phase helps in detecting hypervascular lesions, such as hepatocellular carcinoma or metastases, as they typically show increased enhancement compared to the surrounding liver parenchyma.
Portal venous phase: The portal venous phase follows the arterial phase and is timed to capture the contrast agent as it perfuses the liver through the portal vein. This phase provides information about the liver's portal venous system, including the hepatic veins, portal veins, and their branches. It helps in evaluating liver parenchyma, detecting hypoenhancing lesions, and assessing liver blood supply and perfusion.
Delayed phase: The delayed phase, also known as the equilibrium phase, occurs several minutes after contrast injection. It allows for better visualization of certain lesions, particularly those that retain contrast material for a longer duration. This phase is especially useful for identifying lesions with delayed washout, such as some types of metastases or hemangiomas.
By capturing the liver in multiple phases, the triphasic CT protocol provides comprehensive information about the liver's arterial supply, the portal venous system, and delayed enhancement. This enhances the detection and characterization of liver lesions, assists in staging liver tumors, and helps in surgical planning or other interventions.
some general CT scan findings that may be indicative of gallbladder carcinoma:
Gallbladder wall thickening: Carcinoma of the gallbladder often leads to thickening of the gallbladder wall. The CT scan can measure the thickness of the wall and assess if it is irregular or infiltrative in appearance.
Mass or tumor: A CT scan may reveal the presence of a mass or tumor within the gallbladder. The tumor can vary in size, shape, and location within the gallbladder. It may appear as a focal lesion or involve the entire gallbladder.
Invasion of adjacent structures: Gallbladder carcinoma can invade nearby structures, such as the liver, bile ducts, or blood vessels. CT imaging can help identify the extent of invasion and the involvement of adjacent structures.
Lymph node enlargement: Carcinoma of the gallbladder can spread to nearby lymph nodes. The CT scan can detect enlarged lymph nodes in the surrounding areas.
Distant metastases: In advanced cases, gallbladder carcinoma can spread to distant organs such as the liver, lungs, or bones. CT imaging may reveal the presence of metastatic lesions in these locations.