MRI Perfusion Of Primary Live Cancer Intervention In The Application And Argon-helium Knife Joint Treated With Treatment Of Primary Liver Cancer Clinical Research

PartⅠ:Interventional magnetic resonance perfusion in primary liver cancer therapyObjective:Of MR perfusion imaging to detect primary liver embolization before and after liver hemodynamics and clinical application.Methods and materials:Of 36 patients HCC patients, hepatic artery embolization, respectiverly on before embolotherapy and embolization three days after 30 days or thotopic liver perfusion scan by MR fat inhibit Turbo-flash sequence do hengduan bits perfusion imaging. Scanning parameter:TI300 ms, TR 533 ms, TE 110 ms, matrix 202×256, FOV 300 mm, turn over angle 20°,1 gathering image formation. Each level scans 240 times, each time 2 s, starts group note contrast agent Gd-DTPA from the 15th scanning, the amount used is 0.2 ml/kg, injection rate of discharge 3 mL/s; Liver perfusion on parameters were calculated and analyzed statiscally.The selection simultaneously includes the liver spleen, the aorta and the portal vein traverses the stratification plane good multi-layer dynamic scanning. ScanningResults:36 patients with HCC patients with hepatic artery embolization before and after three days and embolization of 30 days or thotopic perfusion scan, MR. Comparing of the PWI of the center and periphery of the PHC,significant statistical differences were existed on HAP,PVP and hepatic perfusion index (HPI). Primary hepatic carcinoma showed obviously high perfusion on hepatic artery phase (HAP) and low perfusion on portal vein phase (PVP) (P< 0.05). The PWI on HAP and HPI of lesion center were higher than that of periphery and the PWI on PVP was lower in the lesion center compared with that of periphery. No statistical difference of total liver perfusion (TL P) was existed (P> 0.05). The PWI on PVP of lesions with blurred margin were higher than that with clear margin indicating more portal blood flow was existed in the former.Conclusion:MR perfusion imaging can quantify the blood flow volume of liver accurately. It can reflect the hemodynamic changes after TACE at certain extent. PartⅡ:Effect of cryoablation by employing Argon/Helium subsequently combined with TACE on primary hepatic carcinomaObjective:To evaluate argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) in treating primary hepatocellular carcinoma by comparing the changes of AFP level and Tumor entity change Discussion argon-helium cryoablation alone and with that obtained after the treatment of TACE alone.Methods and materials:(1) 176 patients with primary hepatocellular carcinoma were randomly divided into three groups A(n=53), treated with TACE and group C(n=53)treated with argon-helium cryoablation together with TACE with argon-helium cryoablation group B(n=73),treated.The patrents gender,age and pathology of three groups were comparable with each other. (2) The peripheral blood Tumor entity change and APF level both before and after the treatment were determined and the results were statistically compared.Results:After the treatment the AFP and Tumor entity change level in all 3 groups was significantly reduced when compared to that determined before the treatment (P<0.05). And the difference in the decrease of AFP and Tumor entity change lever between group C and A, also between group C and B was statistically significant (P<0.05).Conclusion:The statistic analysis of APF and Tumor entity change which are regarded as the index of therapeutic efficacy, indicates that argon-helium cryoablation combined with TACE is superior to simple argon-helium cryoablation and also to simple TACE in the treatment of primary hepatocellular carcinoma.