 So my paper presentation is role of multi-phasic city and focal hepatic tumors. So liver being one of the largest organ in the body is the site for wide gametes of benign and malignant neoplasm. It is also one of the bombless site for metastatic neoplasm for primary tumor cells. So detection of hepatic lesions with CT can be optimized by rapid delivery of iodinated contrast material and scanning during phase of the maximum difference in attenuation between the neoplasm and the normal parenchyma. Normal liver parenchyma receives about 70% of its blood from the portal vein and 30% from the hepatic artery. So most of the primary and metastatic liver tumors, however, receive their blood from the hepatic artery. Thus scanning the liver sequentially in different phase of enhancement allow detection of both hypervascular and hypopascular tumors. So aims and objective of my study to study the pattern of enhancement of liver neoplasm in arterial phase, portal menoplasm, delayed phase and thereby characterizing the mass. So this study was, this was a retrospective study conducted in department of radiative diagnosis, 3JMC down here at Karnataka for a study period of one year. The total 72 patients were selected for the study in whom diagnosis was made by losing USG graded or CT graded FNSE or biopsy or by typical imaging features or by clinical and laboratory phoenix. So scanning parameters are RTL phase has taken at 20 seconds, portal menoplasm has taken at 60 seconds and the other phase has taken at 180 seconds. So observations and results. The most common liver neoplasm of metastasis which is seen on 26 patients, then the second most was the SCC which is seen in 25 patients and third most was the hemangioma and last was the cholangocarsinoma. In age distribution, most common age of presentation was 50 to 75 years with mean ages being 53 years. So clinical spectrum, most common clinical spectrum was clinical presentation was plane abdomen which is seen in 43 patients, second most common was hepatomeregal which is seen in 35 patients, rest of the clinical research like abdominal distention, loss of weight, down days, mass per abdomen, asides or pleural equations also seen. So first is the hepatocellular casinoma, pattern of enhancement of hepatocellular casinoma. The hepatocellular casinoma was seen in 25 patients and the most common pattern of enhancement in RTL phase was heterogeneous which is seen in 68% of the patients and in hypotelenos and the equilibrium phase it was the hypomanagement pattern was seen which was the most common pattern of enhancement which is seen in 40% in total venous phase and 68% in equilibrium phase. So this is a case of hepatocellular casinoma where you can see there is heterosynecyparypheroly heterosynecyparypheroly enhancing mass lesion noted in the right lobe of the liver which is in the arterial phase which is showing washout in total venous and delay phase. Second is the metastasis. The most common primary for the liver metastasis was the colorectal casinoma which is seen in 7 patients. Next common was the CA bankrails and third most common was the CA stomach and ovary. Rest of the casinoma primary was the breast, meloma, RCC, CA is the first after it. So pattern of enhancement in metastasis, the most common pattern of enhancement in arterial phase was peripheral enhancement which is seen in 43% of the cases. In total venous phase again the peripheral enhancement was the most common pattern of enhancement. In equilibrium phase it was the hypo enhancement which is seen in 74% of the patients. So this is a case of metastasis from colorectal casinoma, primary is the colorectal casinoma where you can see there are multiple peripheral enhancing, peripheral enhancing lesions noted in the diffusely in the liver in arterial phase which is showing washout in equilibrium phase. In portal venous we can see there is peripheral enhancement is there. So next is the hemangioma, the hemangioma is seen in 14 cases. So the most common enhancement pattern in arterial phase was peripheral globular enhancement which is seen in 78% of the cases, in portal venous phase again it was peripheral globular enhancement. In equilibrium phase it is uniformly hyper enhancement. So this is a case of hemangioma where you can see there is in arterial phase there is peripherally discontinuous nodular enhancement noted in the arterial phase which is showing progressive centripetal filling in portal venous and in equilibrium phase it is showing almost complete hyper enhancement of the lesion which is very deep color of hemangioma. Next comes the colorectal casinoma, it is seen in 7% of 7 patients, most common pattern of enhancement was in arterial phase was peripheral enhancement they seen in 42% of the cases. In portal venous phase most common enhancement was again peripheral enhancement, in equilibrium phase it was most common pattern of enhancement was hyper enhancement, means delayed enhancement. So this is a case of colorectal casinoma where you can see there is heterogeneous enhancement of the lesion noted in the left side of liver in the arterial phase. In portal venous also there is heterogeneous peripheral enhancement but in delayed phase it is showing hyper enhancement of the non-enhancing liver which is shown in the arterial phase. So this is typical enhancement pattern of colorectal casinoma. So enhancement pattern in arterial phase for HCC most common enhancement pattern was heterogeneous enhancement which is seen in 68% of the cases, for metastasis ring enhancement which is seen in 42% of the cases, for hemangioma it is peripheral globular enhancement which is seen in 78% for colorectal casinoma it is ring enhancement which is seen in 42% of the cases. So positive predictive value, the positive predictive value for abnormal internal vessels for heterogeneous enhancement in HCC was 73%, positive predictive value for peripheral ring enhancement pattern in metastasis was 84%, positive predictive value for most common enhancement pattern of hemangioma was 100%. So on summary, total 72 cases were included in the restores for HCCD, most common pattern of enhancement which is having high positive predictive value for hepatocellular casinomas abnormal intratumoral vessel or variegated pattern or heterogeneous pattern. Most common pattern of enhancement for hemangioma was peripheral globular enhancement with centrifugal filling up. In case of metastasis it was peripheral ring enhancement in the arterial and portal venous phase was more specific with high positive predictive value. In case of palangio casinoma peripheral ring enhancement, conglomerated lesions with intratumoral hyperattunation in the delayed phase, that means delayed enhancement. So conclusion, multifasic liver CT proved to be valuable pool in the diagnosis of liver neuroplasm by setting different patterns of enhancement of primary and secondary neuroplasm, arterial, portal and delayed phase, helping diagnosing the tumor confidentially thus characterizing the hepatic tumors in three phases instead of single phase was useful in more accurate diagnosis of hepatic neuroplasm and help in reaching the near histopathic liver diagnosis. So these are my references. Thank you.