Application Value Of 320-Detector CT Perfusion Imaging In Evaluating The Efficacy Of Hepatocellular Carcinoma After TACE

Objective:To assess the clinical application value of 320-detector CT perfusion imaging in evaluating the efficacy of hepatocellular carcinoma after TACE.Methods:Thirty-six patients with hepatocellular carcinoma(HCC)who underwent TACE treatment at the Affiliated Hospital of Yanbian University from March 2016 to December 2016 were examined by the CT perfusion,Contrast Enhanced CT,CECT(arterial and portal phase)and MRI.Quantitatively analyze the relationships of perfusion parameters of the residual or recurrent lesions and surrounding normal liver tissue,including hepatic arterial flow(AF),portal flow(PF),and perfusion index(PI),and also observe the time-density curve of the lesions and normal liver tissue.Results:47 lesions were evaluated in 36 patients,42 residual or recurrent lesions were found in CT perfusion.1.The perfusion parameters of the normal liver,AF was 33.50 ± 10.74(ml/min/100ml),PF was 130.05 ± 36.70(ml/min/100ml),PI was 21.09 ± 5.85;The residual or recurrent lesions perfusion parameters in HCC after TACE as follow,AF was 103.61 ± 30.56(ml/min/100ml),PF was 35.67 ± 24.09(ml/min/100ml),PI was 76.32 ± 13.70.There was a significant difference between two groups(P<0.01).AF and PI of the residual or recurrent lesions were significantly higher than that of the normal liver tissue,PF of the the residual or recurrent lesions was significantly lower than that of the normal liver tissue.2.By comparing residual or recurrent lesions and normal liver tissues through the peak enhancement time of the time-density curve,the residual or recurrent lesions peak time of the enhancement was 21.6 ± 4.1(s),normal liver tissues peak time of the enhancement was 51.7 ± 6(s),there was a significant difference between them(P<0.05).The residual or recurrent lesions showed a rapid rise and down,the enhancement of lesions in the arterial phase reached the peak,then decreased;the enhancement of normal liver tissues increased slowly and reached the peak in the venous phase.3.Consider MRI evaluation results as the standard,CT perfusion was more reliable in evaluating the efficacy of TACE,The Kappa value is 0.69;The sensitivity was 97.6%,the specificity was 66.7%.Conventional enhanced CT is less reliable,Kappa value is 0.33;The sensitivity and specificity were 73.2%and 83.3%,respectively.4.The effective radiation dose(10.2mSv)of CT perfusion imaging technique was lower than that of Conventional 3-stage liver enhancement CT(28.34 ±5.9mSv),there was significant difference between them(P<0.05).There was no significant difference between CT perfusion + conventional 2-stage liver enhancement CT radiation dose(28.16±3.6 mSv)and conventional 3-stage liver enhancement CT radiation dose(28.34±5.9mSv)(P>0.05).Conclusion:CT perfusion parameters can be used to quantitatively analyze the microvascular perfusion in residual or recurrent lesions of liver cancer after TACE.The CT perfusion maps can directly find tumor lesions;Compared with conventional contrast enhanced CT,CT perfusion imaging has higher reliability and detection rate of residual or recurrent lesions of hepatocellular carcinoma after TACE;The effective radiation dose of CT perfusion is lower than that of CECT.