الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) is the most frequent malignant neoplasm of the liver in adults and is the leading cause of death among persons with cirrhosis. The increasing incidence of HCC is related to the longer survival of patients with cirrhosis as the result of improved therapies.
Liver transplantation has been considered to be the only causal treatment for liver cirrhosis patients with hepatocellular carcinoma (HCC) due to its theoretical advantage of eliminating both the tumor and liver disease. However, because of the shortage of donor organs, it is strongly recommended that liver transplantations should be performed on cirrhotic patients with HCCs only when the patients meet the predetermined criteria in terms of number and extent of HCCs. Imaging is thus decisive in the patient inclusion or exclusion from transplantation lists.
The Milan criteria are at the present time the accepted and recommended measure to determine the liver transplantation candidacy of patients with hepatocellular carcinoma. This criteria described in a landmark paper by Mazzaferro and colleagues, demonstrated that in patients with cirrhosis and a single tumor up to 5 centimeters, or up to three lesions none larger than 3 centimeters, and with no evidence of extra hepatic spread or macrovascular invasion, the 4-year post-transplant survival was similar to that of recipients transplanted for reasons other than liver cancer,. Despite being validated, some believe that the Milan criteria are too restrictive and exclude a subset of patients with larger or more numerous tumors that could have excellent outcomes if were transplanted. This study includes 35 patients (29males &6females) with their age ranged from 39 to 60 years old, presented to transplantation unit of National liver Institute. In the period between May 2013 and December 2014.
All the patients were subjected to full history analysis, clinical examination, full laboratory investigation including AFP, Ultrasound with Doppler study and Triphasic CT study.
In all cases, gross and histopathological analysis of the explanted liver were performed finally the imaging findings were correlated with histopathological findings in the explanted livers on a patient-by-patient and a lesion-by-lesion basis.
This study revealed that sensitivity of MDCT in detection of HCC using patient by patient analysis was 90.3 % , its specificity 50 %, False positive results 50%, False negative results 9.7% , PPV 93.3% NPV 40% & its accuracy 85.7% .As expected, in our study the sensitivity of MDCT for nodules decreased with lesion size. We found very good sensitivity for HCCs larger than 20 mm (88%), acceptable sensitivity for nodules measuring11–20 mm (84.6%), and low sensitivity for nodules 10 mm or smaller (62.5%), after Comparison between Milan application on CT results basis and that after histopathological results there was no significant difference (p value= 0.09)