The Value Of Contrast-Enhanced Ultrasound And Contrast-Enhanced Computed Tomography In Evaluating The Postoperative Efficacy Of TACE For Hepatocellular Carcinoma

ObjectiveTo explore the value of contrast-enhanced ultrasonography ?contrast-enhanced CT and the combination of the two in the treatment of hepatocellular carcinoma with transcatheter arterial chemoembolization,in order to provide more reliable monitoring methods for the clinical evaluation of TACE treatment,so as to accurately discover Residual or recurrent lesions in order to take the next step of treatment as soon as possible to improve patient survival.MethodsA total of 50 patients(76 lesions)who were confirmed by pathology as hepatocellular carcinoma and who were treated with TACE for the first time from October 2016 to October 2018 were enrolled.All patients were admitted to our hospital within 1 months after surgery.CEUS,enhanced CT,and enhanced MRI were performed to evaluate the efficacy.Finally,the results of enhanced MRI examination were used as evaluation criteria,and the value of CEUS,enhanced CT and their combination in the evaluation of postoperative TACE was evaluated.All patients underwent CEUS,enhanced CT,and enhanced MRI at 1 months after TACE.All three tests were completed within 2 weeks.Results1.According to the results of enhanced MRI of 76 liver cancer lesions,49 lesions were residual or recurrent,and 27 lesions were completely inactivated.The sensitivity of CEUS,enhanced CT and their combination in the diagnosis of residual or recurrent liver cancer after TACE was 87.76%,81.63% and 91.84%,respectively.The specificity was 96.30%,92.59% and 92.59%,respectively.The coincidence rates were 90.79%,85.53% and 92.11%,respectively.2.The sensitivity,specificity and coincidence rate of CEUS for the diagnosis of residual or recurrent foci after TACE were better than those of enhanced CT(P<0.05).The sensitivity and coincidence rate of the combination of CEUS for the diagnosis of residual or recurrent foci were better than those of the patients.CEUS and enhanced CT examination were performed(P<0.05).3.Enhanced CT,CEUS and the combination of the two patients with residual or recurrence of TACE after liver cancer and MRI diagnosis results are consistent,k values are 0.701,0.807,0.830,respectively,indicating CEUS and their combined diagnosis and MRI diagnosis The degree of agreement is higher.Conclusions1.Enhanced CT examination is the most commonly used and effective imaging examination method for evaluation and follow-up of TACE after liver cancer.It can not only evaluate target lesions and distribution of lipiodol,but also comprehensively observe all lesions of the whole liver.And the involvement of adjacent organs has a unique value for the evaluation of the efficacy of TACE after liver cancer.?2.CEUS examination can clearly show the tumor residual and necrotic area after TACE,accurately show the blood supply within the lesion,not affected by lipiodol,and CEUS non-invasive,no radiation,safe,rapid,reproducible,is to assess liver cancer In the long-term survival monitoring,CEUS can be used as a common and important non-invasive auxiliary examination method for enhanced long-term survival monitoring.3.CEUS and enhanced CT have their own advantages and disadvantages,combined diagnosis can complement each other,improve the diagnostic accuracy and sensitivity of residual or recurrence of TACE after liver cancer,reduce the rate of missed diagnosis,and provide patients with accurate postoperative evaluation and maximum The patient is protected from invasive examination and provides a scientific theoretical basis for the clinical.