Analysis Of Newil Found Transient Hepatic Intensity Differences In HCC Patients Had Accepted TACE Combined With HIFU Therapy

Objective:To observe the feature of transient hepatic Intensity disorders(THID)that newly found around the focus that had gone through Transhepatic Arterial ChemOtherapy And Embolization(TACE)combined with High intensity focused ultrasound(HIFU)therapy in hepatic carcinoma patients, and explore the possible mechanism of these THID, in order to give more guidance to Clinician to make a more reasonable diagnostic work up and formulation of a treatment plan.Methods : We retrospectively examined the records of 158 consecutive patients(139 men,19 women;mean age,51.4[range, 25–81] years) who underwent dynamic MRI and newly found at least one place THID around the primary lesion in patients who suffered from hepatic carcinoma and had gone through TACE combined with HIFU therapy between 2010.11-2016.01. Make a comprehensive analysis base on the MRI and Digital subtraction angiography(DSA), assess the relationship between the form of THPD and the mechanism of it.Results:158 patients in total 288 places THPD was founded around 203 focuses.104(36.1%) places are ring-shaped, 72(25.0%) places are Polymorphous,59(20.4%) places are wedge-shaped,39(13.5%) places involve loba or multisegmental,14(5.0%) places are nodule-shaped.161(55.9%) places of the THID are saw in the first follow-up after surgery(1 week to 1 month),the rest 127(44.1%) places are not.133(46.2)places of them disappeared in the follow-up period,139(48.2) places of them persistent throughout the follow-up period,16(5.6%) places of them in the follow-up period new hepatic carcinoma lesions are saw in the THID area.98 places of them are together with vascular anomaly,among which 45(45.5%) places of them are together with Arterioportal Shunt(APS) and portal vein tumor thrombus(PVTT) at the same time,29(29.6%) places of them are together with APS,24(24.2%) places of them are together whit PVTT.The ring-shaped and polymorphous THID around the lesion that have gone through TACE combined with HIFU therapy are mainly caused by iatrogenic injury/inflammatory,wedge-shaped THID and that involves lobar or multisegmental are mainly caused by the formation of PVTT and APS.Conclusion:It is common to see the THID around the primary lesions in HCC patients who have gone through TACE combined with HIFU therapy,it may prompts new pathological changes,The MRI performance and forming reasons are varied,accurate judging of the formation mechanism of the THID can guide the clinician to make a more reasonable diagnostic work up and formulation of a treatment plan for patients.