Value Of CT During Arterial Portography In The Course Of TAE Therapy For Hepatocellular Carcinoma

PrefaceTranscatheter arterial chemoembolization ( TAE) is considered a chief therapy in advanced hepatocellular carcinoma. It is very important to evaluate its efficacy and recurrence or metastasis for the further interventional therapy. However, there is no identical standard reex-amination at present. CT during arterial portography (CTAP) is one of the most sensitive imaging techniques to detect focal hepatic masses , but is not paid much attention to reexamine the patients who ha4 performed TAE therapy. In this study, we analyzed the clinical value of CTAP in the course of repeated TAE therapy compared with other imaging modalities.Materials and Methods26 patients with hepatocellular carcinoma were chosen in this study. The patients population was composed of 24 men and 2 women, aged 46 -74 years ( mean, 59.72 years). All patients had the CTAP images before the first TAE therapy. It amounted to 47 CTAP reexami-nations. 19 patients underwent 28 CT examinations before TAE, 16 cases underwent 24 CT examinations after TAE. The interval from CTAP to other imaging methods was no more than two weeks. 11 cases were performed with a Picker 2000 scanner (Piker, America) ,15 cases with MX8000 multislice CT scanner (Philips, Holand ).The all reexamined CTAP images, preoperative and postoperative CT images in the same period were retrospectively reviewed by two experienced radiologists. A consensus opinion was reached in the fresh foci, recurrence of primitive foci and the presence or absence of portal invasion. The fresh foci and recurrence of primitive foci were determined by gradual growth in size in the follow - up and presence of typical HCC characters on MR or DSA images. The portal invasion was determined by the presence of typical features on MR or DSA images.Statistical analysis of the results was performed with the ?* test. A P value of less than 0. 05 was considered statistically significant. A P value of less than 0. 01 was considered statistically very significant. And a P value of more than 0. 05 was considered statistically no significance.ResultsThe difference in the detecting fresh foci between reexamined CTAP images and Iodized oil CT images after TAE was significant. It was significant in detecting small fresh foci (no more than 3cm) , especially in tiny foci (no more than 1cm) compared with the postoperative iodized oil CT images (0.010.05) .The presence or absence of recurrence of 24 primitive tumors ( 19patients ) was evaluated by CTAP and CT images before repeated TAE therapy. The preoperative images distinguished 19 lesions (14 cases) correctly. The CTAP images distinguished 22 lesions (17 cases), there were no very significant differences between the two means(0.01