| Hepatocellular carcinoma is the most common malignant tumor of the liver and is one of the most common tumors in the world, causing an estimated 1 million deaths per year. Transhepatic arterial embolization (TAE) is a treatment option for inoperable hepatocellular carcinoma , The use of TAE induces tumor necrosis, improves tumor resectability, reduces the likelihood of recurrence, and improves quality of life and survival time . Although the therapeutic outcome of TAE depends on the adequacy of the obstruction of tumor blood supply, an accurate measurement of tumor blood perfusion has never been available for the clinical practice of TAE, mainly because of the lack of an applicable technique. Almost 30 years after the introduction of TAE into clinical practice and worldwide use, basic TAE techniques—such as selection of the type and dosage of the embolic agent used, the timing and frequency of repeat TAE, and the criteria used to evaluate the procedure's sufficiency and its relationship with therapeutic results—continue to be subject to personal experience and based on inaccurate estimations of blood supply to the tumor calculated on the basis of results of arteriography. conventional computed tomography (CT). and magnetic resonance imaging. This lack of standardization has hindered efforts to improve techniques and maximize the therapeutic benefits of TAE. It has also been difficult to evaluate the efficacy of TAE as reported by different institutions, at which various techniques and estimation criteria have been used .In recent years, functional CT has been developed to enable quantitative measurement of tissue perfusion, and its development has expanded CT from a purely anatomic imaging technique to a combined morphologic-physiologic technique . Because of its easy accessibility and simplicity, functional CT has been used in the monitoring of hepatic carcinoma after TAE therapy. Functional CT has also shown potential in the early detection of hepatic tumors, cirrhosis, and other pathophysiologic conditions in various organs .The purpose of our study was to quantify tumor perfusion before TAE with functional CT and non lipiodol deposition area, including residual tumor and relapse, necrotic tissure were excluded, hepatic perfusion parameters were observed and analyzed, activity of non lipiodol deposition area was validated.Objective To provide necessity of reintervention for hepatocellular carcinoma (HCC), the blood perfusion change of hepatocellular carcinoma (HCC)before and after transcatheter arterial chemoembolization ( TACE) is analyzed with CT perfusion imaging ( CTPI)MATERIALS AND METHODS CT perfusion scans were performed 2 days in 32 patients before interventional treatment and 30 days in 25 patients after TACE with HCC. The perfusion parameters of HCC lesions,non lipiodol deposition area post-operation (including residual tumor and relapse, necrotic tissure were excluded) were measured, including the values of blood flow (BF) , blood volume (BV) , mean transit time (MTT). permeability ( PS). hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP) , portal vein perfusion ( PVP) and hepatic perfusion indexes were observed and analyzed. Correlations between hepatocellular carcinoma (HCC) pre-after operation and non lipiodol deposition area post-operation including relapse and metastasis perfusion index were also analyzed. Statiscal analysis was done with SPSS 12.0 software. All the data was expressed by mean±SD, comparison was made by T-test.significance was accepted when P<0.05. Result HBF,HBV,MTT,PS,HAF,HAP,PVP of hepatic carcinomas between pre- operation and post-operation (non lipiodol deposition area) respectively were 325.36±59. 42 ml/ (100g. min),54.22±9. 73ml/100g,10. 62±1. 93 s,38.57±7. 30ml/(100g. min),0.82±0.05,269.71±59. 93ml/(100g. min),55.68±10. 75 ml/(100g. min), 236.96±61.20 ml/(100g. min),37.37±8.97 ml/ 100g,9.79±1. 66 s,39.45±8.18ml/ (100g. min),0.79±0.06,174.31±49. 73 ml/(100g. min),63.29±18.00ml/(100g. min), HBF, HBV, HAP of hepatic tumors between pre- operation and post-operation (non lipiodol deposition area) in HCC lesions were statistically significant, MTT,PS,HAF,PVP were not significant among the parameters in HCC lesions before therapy and after therapy. Hepatic rumors pre- operation demonstrated that it go up fast and go down slowly on TDC , Hepatic carcinoma showed hyperperfusion on CTPI,Value of HPP makes no deference between pre and after operation,Perfusion was not found in the lipiodol area, and the TDC was a horizontal line. Conclusion The CT perfusion parameters provides therapeutic proof of re-intervention and plays a important role in guidance of interventional treatment for hepatocellular carcinoma.
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