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CT Triple Phase Liver

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Non-Contrast (optional) Non-contrast Diaphragm to Iliac crests
    Late Arterial Arterial (16 sec delay) Diaphragm to Iliac crests
    Portal Venous Contrast (70 sec delay) Diaphragm to Lesser trochanters
    Delayed Phase Contrast (300 sec delay) Diaphragm to Iliac crests
    • Liver lesion characterization
    • HCC surveillance
    • Liver mass protocol

  • 2. Patient Prep

    • Position: Supine with arms raised
    • NPO Status: NPO 4 hours
    • Pre-Medication:
      • None typically. Oral contrast optional

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 1.5 mL/kg
    Flow Rate 4-5 mL/s
    Duration 25s
    Timing Method Triple phase: NC + Arterial + Portal Venous + Delayed
    ROI Placement Abdominal aorta
    Trigger (HU) 150 HU

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • FOUR acquisitions: 1) NC abdomen 2) Late arterial (bolus track or 30-35s) 3) Portal venous 70s 4) Delayed 5 min. FOV: Abdomen for NC/Art/Delay. Full AP for PV
    • Injection duration is fixed at 25 s
    • 20-22G IV. High flow rate critical

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history
    • NC: characterize lesion. Arterial: hypervascular lesions HCC. Portal: most liver lesions. Delayed: washout pattern
    • High flow rate. Extended 5 min delay. Breath hold coaching
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Diaphragm Iliac crests N/A N/A AP
Non-Contrast Diaphragm Iliac crests N/A 2.5 mm Liver FOV
Late Arterial Diaphragm Iliac crests 30-35 sec or bolus track 1.25 mm Liver FOV - hypervascular lesions
Portal Venous Diaphragm Pubic symphysis 70 sec 2.5 mm Full AP FOV
Delayed Phase Diaphragm Iliac crests 300 sec 2.5 mm Liver FOV - washout assessment
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial All phases Liver 2.5 mm/2.5 mm Standard 3 Compare all phases
Axial Portal venous Full AP 2.5 mm/2.5 mm Standard 3 Full abdomen pelvis PV
Coronal All phases Liver 3 mm/3 mm Standard 3 Coronal comparison
Subtraction Arterial - NC Liver 2.5 mm Standard 3 Enhance lesion conspicuity