The Effect Of CT Perfusion Imaging In The Evaluation Of Embosphere TACE Microspheres Embolization

ObjectiveTo assess the clinical value of Embosphere microspheres embolization treating HCC patients with the use of CT perfusion imaging (CTPI).MethodsCollected HCC patients who treated with Chemoembolization in Yunnan First People’s Hospital from January 2013 to March 2015 as the research object. It was divided into two groups according to Embolic material:Patients in Control Groupwere given CT perfusion scans and simple microspheres embolization, depending on the type of liver cancer and tumor blood supply size, the choice of icro-embolization of tumor regions of different diameter vessels to block the blood supply, re-perfusion scan CTPI after 15 days. Patients in Experimental group were given preoperative CTP examination, lines Embosphere microspheres+iodized oil joint embolism,1/2 or 2/3 to give iodized oil embolism, after blocking the using of different size according to the diameter of the tumor micro-embolization of vascular tumor area vessels, re-CTP check after 15 days.Colorful perfusion maps of the 20 cases of control group and 40 cases of primary liver cancer were got by Dual-source CT perfusion scan. Perfusion parameters include MIP、BF、BV、PMB、ALP、PVP. HPI.The color images were analyzed to obtaine perfusion parameters and the blood flow perfusion changes of HCC tissue before and after TACE treatment was observed. At the same time a comparative assessment with the number of patients with embolism, liver function before and after surgery, serum alpha-fetoprotein (AFP) levels, changes in tumor size and embolic complications associated should be conducted.ResultsThe results of CTPI suggest that before TACE, the BF, BV, PBM, ALP, PVP and HPI index in the control group and the group of HCC patients showed no significant differences. Before TACE, the index of BF, BV, PBM, ALP, PVP and HPI in the control group and the group of HCC patients showed no significant differences. After TACE, perfusion parameters of BF, BV, PBM, ALP, PVP and HPI showed lower than the mean preoperative respectively, and PVP increased compared with preoperative. Comparison between the two groups for postoperative displays that the perfusion index of BF, BV, PBM, ALP, PVP and HPI in HCC group showed lower than the control group, but PVP increased than the control group, the differences were statistically significant.Clinical analysis of two samples suggest, the number of patients receiving treatment in the experimental group was significantly less than the control group of patients, respectively,1.32 ± 0.79 times and 2.03 ±1.14 times, the difference was statistically significant. The tumor area of the control group and the experimental group were both significantly lower and tumor area in which to reduce the rate of the experimental group higher than the control group, but no statistically significant. Comparison of AFP value displays, AFP values could effectively reduce postoperative in both groups, but the experimental group reached a level far lower than the control group, the difference was statistically significant.The result of evaluating the safety of Embosphere with liver function and clinical indicators showed that the indicators in the control group and the experimental group before and after TACE was no significant difference, and no difference between the two groups. In signs of complications (average maximum temperature and duration of fever, abdominal pain score and duration of vomiting frequency and duration), the experimental group and control group had no significant difference.ConclusionCT perfusion imaging can quantitatively evaluate changes in blood flow before and after TACE. Embosphere microspheres combined with iodized oil is more promoting liver perfusion than simply combined with iodized oil, it is conducive to the restoration and improvement of liver function. Embosphere embolic microspheres combined with chemoembolization better than chemotherapy alone iodized oil embolism efficacy in treatment of liver cancer, the security almost same. Embosphere TACE combined with iodized oil in TACE embolism has a huge potential to become the non-excisional treatment of HCC.