CT Evaluation Of Of Primary Hepatocellular Carcinoma After Transcathter Hepatic Arterial Chemoembolization Therapy

[Objective]Primary hepatocellular carcinoma(PHCC) is a common malignant tumor in liver.Transcathter hepatic arterial chemoembolization(TACE) is the first choice of methods in treatment advanced liver cancer recognized both at home and abroad. How to accurately evaluate the efficacy of TACE,control residual cancer,improve the curative effect of advanced liver cancer in TACE,control of tumor growth, prolong life time and improve the quality of life is of great significance.In this paper our study the applicable valve of CT in evaluating intervenional therapy response of primary hepatocellular carcinoma.[Materials and Methods]The imaging and clinical data of 100 patients with primary hepatocellular carcinoma after TACE were analysed retrospectively.All of PHCC cases were in line with the diagnostic criteria of China's anti-cancer Association and liver cancer Professional Committee.Male 65 cases,female 35 cases,the age between 32 and 73, with a median age of 45 years of age.Liver function Child-Pugh classification:A grade were 78 cases,B grade were 22 cases,the patient with no obvious jaundice and ascites,no distant metastasis.Femoral artery puncture with Seldinger technique,after ultra-election hepatic artery angiography by celiac artery,patients were teated with TACE.CT examination were used SIEMENS SOMATOM PLUS4 or GE Lightspeed 16 spiral CT scanner.Ehanced scaning were used a dedicated pressure syringe of MEDRAD company.CT contrast agent were Iohexol 300mgI/ml or Ultravist.Observe and measure the lesion morphology,size,Lipiodol deposition and enhance the CT features before and after treatment by PACS workstation,compared with MRI and color Doppler ultrasonography.In accordance with PHCC morphous generally divided into①Huge type;②nodular type;③diffuse type.In accordance with lipiodol in the final deposition form after TACE divided into①complete;②rare type;③patch-type.On the basis of WHO short-term treatment effect of solid tumor evaluation criteria are divided into①complete remission;②partial remission;③stable or no change④progress.SPSS 13.0 software package was applied for the above statistical analysis,x~2 test,testing the standard:a = 0.05,P＜0.05 considered significant difference.[Results]PHCC performance for the CT plain scan showed low density,a small number of showed equal or slightly higher density.And the density were homogeneous or inhomogeneous;Enhanced scaning significantly enhanced in the arterial phase,the enhanced degree of decline in venous phase,low-density in the lag phase.low-density or no enhanced necrotic area were observied in the mass.In 100 cases massive type (including the massive satellite-based) 70 cases,nodular type(including the integration of nodular type) 30 cases.After TACE 30 cases of nodular liver CT showed complete relieve type 28 cases,patch type relieve 2 cases.After TACE 70 cases of massive hepatocarcinoma showed complete relieve type 40 cases,patch relieve type 20 cases,rared type 10 cases.30 cases of nodular liver cancer after 1st TACE complete remission in 28 cases,partial remission 2 cases.70 cases of hepatocellular carcinoma after massive TACE after 1st complete remission in 20 cases,partial remission40 cases,progress 10 cases.The therapy response of TACE and CT findings between massive hepatocellular and nodular hepatocellular carcinoma had significant difference(P＜0.05). [Conclusions]CT can accurately show the before and after treatment of intrahepatic lesion size, number changes,in the form of iodized oil deposition,vascular involvement,changes in hemodynamics and organ metastasis.CT is an effective way in evaluating the efficacy of primary liver cancer after TACE.The CT review time is about four weeks in liver cancer after TACE.We can clearly distinguish between liver and normal liver tissue,directly understanding the blood vessels supplying of the tumor,the source of collateral circulation and anatomical relationship,guiding to formulate the development treatment plan.Hepatocellular carcinoma after embolization with iodized oil deposition of tumor necrosis is positively correlated.Nodular liver after TACE CT features were mostly complete type,short term effect is good.Massive hepatocellular after TACE CT could show as complete remittence,incomplete remittence and thinly scattered type.Incomplete remittence and thinly scattered type short term efficacy is less than complete,needing to revisit TACE treatment or other treatment options.Liver cancer recurrence first occured the edge of the tumor after TACE.CT review should pay particular attention to the edge of the tumor and the department of lipiodol missing.Dynamic contrast-enhanced CT and MRI scans to detect lesions have a decisive role.DWI and PWI MRI could give a help in evaluating the effect of liver cancer after TACE.