The Application Of Contrast-enhanced Ultrasound And Acoustic Radiation Force Impulse Imaging In Evalution Of TACE With Hepatocellular Carcinoma

Objective:The changes in microvascular perfusion and hardness of the lesions were observed by using contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse imaging (ARFI), including virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ) after the interventional therapy for hepatocellular carcinoma. And the clinic value of CEUS and ARFI in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma was also investigated.Method:After TACE treatment in the Yanbian University Hospital,56 patients with hepatocellular carcinoma nodules were examined by conventional ultrasound, CEUS and ARFI, respectively. The changes in hepatocellular carcinoma nodules after TACE treatment were comparative analyzed, and the changes in microvascular perfusion and hardness of the in and around lesions were observed.Results:1. After TACE treatment, there was no statistically significant because of the difference in VTQ between the center and peripheral of the complete inactivation lesion (P>0.05). However, there was an opposite direction that the difference in VTQ between the center and the peripheral of the locoregional residual or recurrent lesion (P<0.05). Furthermore, the difference in VTQ between the center of the locoregional residual or recurrent lesions and the peripheral one was higher than the center of complete inactivation lesion and the peripheral one, indicating the statistically significant (P<0.05).2. The complete inactivation lesion and the the surrounding hepatic tissues were quantitative analyzed by using CEUS and time-intense curve (TIC) when the patients were received TACE treatment. The result showed that the time to peak intensity (TTP), the peak signal intensity (PI), the mean transit time (MTT), and the area under curve (AUC) of the complete inactivation lesions were less than ones of the surrounding hepatic tissues, which is statistically significant (P<0.05).3. The locoregional residual or recurrent lesions and the surrounding hepatic tissues were quantitative analyzed by using CEUS and TIC curve when the patients were received TACE treatment. The result shows that TTP of the locoregional residual or recurrent lesions was less than the one of the surrounding hepatic tissues, which was statistically significant (P<0.05). There was no statistically significant difference between the values of PI, MTT and AUC of the locoregional residual or recurrent lesions and the ones of the surrounding hepatic tissues (P>0.05). Furthermore, the difference in TTP between the locoregional residual or recurrent lesions and the the surrounding hepatic tissues is higher than the complete inactivation lesions and the surrounding hepatic tissues, indicating the statistically significant (P<0.05). The difference in PI between the locoregional residual or recurrent lesions and the the surrounding hepatic tissues was more less than the complete inactivation lesions and the surrounding hepatic tissues, which was statistically significant (P<0.05).Conclusion:After TACE treatment, The microvascular perfusion of hepatic malignant tumor lesions can be real-time dynamic observed and objectively analyzed by using the curves of CEUS and TIC. the changes of stiffness in hepatic malignant tumor can estimated noninvasively and repeatedly by using ARFI. This method has a higher accuracy in measuring the inactivation of tumor, residual and recurrent lesions, and expected to be one of the effective assessments of TACE of liver tumor.