| OBJECTIVE: To evaluate the blood supply of viable tumor area (VTA) of hepatocellular carcinoma (HCC) after transcatheter hepatic artery chemoembolization using lipiodol(LP-TACE), by dual-phase multidetector-row helical computed tomography (MDCT) scanning and three dimensional CT(3DCT).MATERIAL AND METHODS: Thirty-eight patients with 55 HCCs after LP-TACE treatment were examined by plain scanning and hepatic dual-phase MDCT. The performance of VTA on plain scanning and the enhancement patterns on dynamic contrast-enhanced scanning were observed. In contrast-enhanced CT scans, the blood supply of VTA was classified into four types: arterial blood supply, portal blood supply, arterial together with portal blood supply and poor blood supply. At thesame time, 3D CT models of the volume rendering, curved multiplanar reformations, surface shaded display and maximum intensity projection reconstruction of the hepatic artery and portal vein were performed in 16 cases.RESULTS: The VTA appear as a hypoattenuation lesion on unenhanced images, and the CT value of VTA was 37. 71 ±7. 78HU. In contrast-enhanced CT scans, the blood supply of low-density area was classified into four types: arterial blood supply (29 cases), portal blood supply (2 cases), arterial together with portal blood supply (22 cases) and poor blood supply (4 cases). The attribution of portal venous blood supply to VTA was significantly increased after LP-TACE. In the 16 cases, correlations of the VTA to branches of hepatic artery as well as portal vein was revealed well by 3D CT.CONCLUSION: Arterial blood supply and arterial together with portal blood supply are the two main types of the VTA. The attribution of portal venous blood supply to VTA was significantly increased after LP-TACE. Hepatic dual-phase MDCT combining with 3DCT is an effective method in evaluating the blood supply of VTA and the therapeutic effect of HCC after LP-TACE treatment. |
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