الفهرس 
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Abstract
Dynamic CT with arterial, portal venous phase and delayed phase
imaging is considered to be the primary approach for the diagnosis of
HCCs. During arterial and portal venous phases of hepatic dynamic CT,
tumor vascularity and blood supply of the liver determines tumor–liver
parenchyma contrast.
Multidetector CT (MDCT) allows fast, high-quality, thin-section
imaging. The advent of Multidetector CT technique and isotropic voxel,
which permits multiplanar reconstructions, have improved the spatial
resolution of CT, allowing the recognition of small focal liver lesions in
difficult areas (e.g., dome of the liver, subcapsular).
A distinct advantage of Computed tomography (CT) imaging is that
attenuation can be displayed in Hounsfield units. CT imaging has been
primarily used in the diagnosis of focal liver lesions, and not in diffuse
liver disease. Changes in attenuation on unenhanced CT imaging can be
observed in some diffuse liver diseases. However, quantitative
assessment of the density distribution of liver parenchyma showed that
only diffuse steatosis and active alcoholic cirrhosis had significantly
different mean hepatic attenuation values.
This study aimed to highlight the role of Triphasic Computed
tomography in diagnosis of hepatic focal lesions.
This study included 30 patients; 18 males & 12 females with age
ranging between 45 and 70 years. All patients underwent detailed history
taking, clinical examination of the liver and abdomen, and then triphasic
Computed tomography examination of the liver. In these 30 patients, (21)
with history of cirrhotic liver, (5) with history of HCV infection.
Abdominal symptoms are present in (27) patients and absent in (3)
patients, hepatosplenomegaly and ascites are the commonest abdominal
signs.
This study showed that no significant association between history &
abdominal examination of patients on one hand and diagnosis of patients
on the other hand (p > 0.05).
This study showed that the most common diagnosis among patients
was hepatocellular carcinoma (63.3%).Hepatic focal lesions were single
in 56.7% of the patients, while 43.3% had multiple hepatic lesions.
Hepatic focal lesions were bilobar among 36.7% of the patients and
unibolar in 63.3% of the patients.
This study revealed that there was no significant association between
age of patients & their diagnosis (p>0.05). In addition, there was no
significant association between size of lesion and diagnosis (p>0.05).
In this study there is significant relationship between diagnosis of
patients and arterial phase. 94.7% of patients with hepatocellular
carcinoma showed early enhancement while adenoma showed
homogenous and 100% of hemangioma cases showed peripheral fill.
Secondaries in liver showed equal percentage of early enhancement &
heterogenous enhancement (33.3%) & equal percentage of poor & normal
enhancement (16.7%).
Moreover, there is significant relationship between diagnosis of
patients and portovenous phase. 100% of patients with hepatocellular
carcinoma showed washout while adenoma showed gradual washout and
100% of hemangioma cases showed gradual fill. Secondaries in liver
showed heterogenous picture in 33.3% of patients and equal percentages
of poor, normal, washout and gradual washout enhancement (16.7%).
In addition, there is significant relationship between diagnosis of
patients and delayed phase. 100% of patients with hepatocellular
carcinoma showed washout and adenoma showed gradual washout while
100% of hemangioma cases showed centripetal fill. Secondaries in liver
showed equal percentage of washout & heterogenous enhancement
(33.3%) and equal percentage of poor and normal enhancement (16.7%).
This study revealed that associated portal hypertension was
significantly higher in patients with hepatocellular carcinoma (84.2% of
cases with HCC) as the prognosis of patients with cirrhosis and HCC is
related to the neoplasm and to factors related to liver condition, such as
the degree of the liver failure and presence of portal hypertension.