| PrefaceAt present, transcatheter arterial chemoembolization (TACE) has been applied widely as an effective therapy in primary hepatic carcinoma. Furthermore, since TACE is difficult to kill entire tumor cells at one time, remaining viable tumor cells and recurrence are the main problem especially in the large lesion, and it is generally used repeatedly. Angiography is the golden standard to evaluate the tumor vascularity, but it is an invansive technique and the cost is high so as to not suitable for routine follow up. Lately, CT perfusion imaging (CTPI) has been applied because of improving of temporal and spatial resolution. As a noninvasive and functional imaging, CTPI has demonstrated its advantage for e-valuating the blood perfusion in liver disease.CTPI describes a rapid sequence of images acquired after the injection of intravascular contrast medium at the same slice, generates the time - density curve of each pixel in the slice and calculates perfusion parameters by different mathematical models. It can combine fine anatomical details and quantitative information about perfusion in the same scan sequence . The information of blood perfusion can be acquired fully and intuitively by adding new measuring parameter and colour blood - perfusion imaging.PurposeTo assess the vascularity of primary hepatic carcinoma before and after transcatheter arterial chemoembolizalion (TACE) with the quantitative parametersobtained by CT Perfusion Imaging (CTPI).Materials and methods21 patients with primary hepatic carcinoma (male 18, female 3) were enrolled in this study. The diagnosis was confirmed by fine needle biopsy or clinical synthetical diagnosis and following up. The age was 47 - 78 years and mean 61.8 years. 13 patients had single tumor, and 8 patients had multiple tumor. The diameter was between 3cm to 12cm and average value was 7.3cm.CTPI was performed after an intravenous bolus injection of 40 ml contrast material (350mgI/ml) with 5 ml/sec before treatment and one month after TACE for patient. The acquired data were analyzed by using Philips commercial software. Blood perfusion parameter colour - picture and time - density curve (TDC) over region of interesting ( ROI) were created automatically by using software. The value of hepatic arterial perfusion (HAP) , hepatic perfusion index ( HPI) and hepatic portal perfusion ( HPP) in tumor tissue before and after TACE were measured by using maximum slope method.Statistical analysis was done with SPSS 11.5 software. All the data was expressed as mean ± SD, comparison was made by t - test. Significance was accepted when P <0.05.ResultsIn all patients primary hepatic carcinoma was shown as hypervascular lesion on arterial perfusion CT, and hypovascular lesion or no blood supply on portal perfusion CT. The average value of HAP was 45.99 ± 14. 67 ml/min/100g, and that of HPI was 72. 38 ± 15. 34% , and HPP was 17.59 ± 11. 80 ml/min/lOOg which was lower than HAP significantly (P = 0.000) . After TACE the average value of HAP % HPI and HPP was 22. 64 ± 15. 57ml/min/100g, 44. 42 ± 27. 27% and 16. 17 ± 12. 27 ml/min/lOOg. Comparing with pre - TACE the value of HAP and HPI was obviously decreased after successfully TACE (P = 0. 000 and 0. 002) , and the value of HPP was no significant different ( P = 0. |
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