الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
HCC is one of the most common malignancies ranking the third leading cause of cancer deaths worldwide. HCC is mainly supplied by the hepatic artery that becomes the sole supplier of blood for the tumor 90-100% while the normal hepatic parenchyma is supplied mainly by the portal vein 75-80% and the hepatic artery supply only 20-25%of the hepatic blood supply HCC is characterized by rapid tumor growth and vascular invasion with typical tendency to produce small or minute satellite nodules (daughter lesions) frequently located in the vicinity of the main tumor. Diagnosis of HCC is based on clinical evaluation, laboratory tests (especially AFP) and radiological investigations including (US, MDCT, DSA, lipidol CT). Different methods could be used in management of HCC such as liver transplantation, surgical resection and local ablation therapy including (TACE, alcohol injection, radiofrequency and microwave ablation). Several factors affecting the choice of therapy of HCC such as the functional status of the liver especially in cirrhotic livers which can be assesed by child Pugh classification, also the size, site and number of the hepatic lesion as the best results of treatment are achieved with small and few lesions. So HCC should be discovered early which is the role of variable imaging techniques. In our study we selected three imaging modalities (triphasic MDCT, DSA and lipidol CT )to compare their sensitivity in detection of small HCC taking lipidol CT the reference of this comparison due to its superior ability to detect small HCC proved by many studies. For this purpose 50 patients known to have hepatic focal lesions on top of cirrhotic liver were further assessed for number and size of other small Fls by base line CT study, DSA and post embolization CT study, then data collected and further categorized according to size into A, B and C to be compared. We resulted that; DSA detected 142 focal lesions and this is higher than those detected by base line CT study (97 lesions). And as post embolization CT study (the reference 100%) detected164 focal lesions so; DSA detected 86.6% of total number of the small lesions while base line CT study detected 59.15%. So DSA has higher sensitivity 87% than baseline CT study 78% and higher specificity 94% than baseline CT study73%. And for categorization of the lesions according to their size into A<1cm, B=1-2cm, C=2-3cm: DSA detected higher percent of focal lesions than those detected by base line CT study in every category noting that post embolization CT is the100%) as follows; • Category A: DSA detected75.75%while baseline CT detected 33.33%. Category B: DSA detected 92.6% while baseline CT detected 74.3%. Category C: DSA detected 96.43% whilebaseline CT detected 82.14%.