Evaluation Of The Blood Supply In Middle-late Stage Primary Hepatic Carcinoma: Comparison Of DSA And CTA Imaging

Purpose: To evaluate the blood supply in middle-late stage primaryhepatic carcinoma. Material and Method: Thirty-one cases with middle-late stage primary hepatic carci- noma, proved by pathology or clinical, before their first TACE, all underwent digital subtract angiography (DSA) and computed tomographic angiography (CTA) of the liver, including hepatic arteriography, indirect portalography through superior mesenteric artery(SMA), and computed tomographic hepatic arteriography (CTLIA) , computed tomographic arterial portography (CTAP). During CTHA and CTAP, single level dynamic scanning were performed in all patients, and the CT value of tumor, normal liver, spleen, aorta abdominalis and muscle in every paiteint were measured, and the time-attenuation curves were made. Lipiodol CT (Lp-CT) were performed 2 week after TACE. All of the results were observed. Results: All of 31 cases showed the evidence of blood supply from hepatic artery, 28 cases(90.3%) simply from hepatic artery, 3 cases(9.3%) from hepatic artery and collateral arteries, and no case showed the sign of the portal vein supply. In single level dynamic scanning of CTHA and CTAP, the time-attenuation curves showed the degree of enhancement between the tumor and muscle tissue have significant deference in CTHA(PO.05) The square of the tumor at the same level showed in CTHA and CTAP had no significant deference (P>O.05). Conclusion: The results of several kinds of method showed that all the tumors, in 31 cases with middle-late stage primary hepatic carcinoma, obtained blood supply from hepatic artery or hepatic artery and collateral arteries, and none from the portal vein; The use of DSA and CTA, in addition to being invasive and costly, is very important in evaluation of the blood supply in middle-late stage PHC, especially before TACE.