Evaluation Of MRI In Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization With Lipiodol

Object To study MRI ,including FSE T2WI and FMPSPGR dynamic contrast scanning,in assessing image characterize and clinical value of HCCs after Transcatheter Arterial Chemoembolization with Lipiodol .Method Thirty patients with 37 original HCC leisions from 2000.9 to 2004.7 were enrolled in this study. All patients underwent MR or CT before TACE and confirmed in pathology by punch biopsy with US or operation. MRI with GE 1.5T was performed in all patients in 2～6 months after TACE, DSA was subsequently carried out in 2～6 days after TACE. All leisions showing negative in DSA will do clinical follow-up beyond six months and combine AFP. The signal intensity of all leision on FSE T₁WI, T₂WI and the enhancement patterns on FMPSPGR dynamic contrast scanning were observed. The signal intensity of necrosis or residual viable tumor after TACE was studied and the coincidence indecting the residual viable tumor between MRI and DSA were evaluated, and the data were compared with the result of clinical follow-up beyond six months (mean 10.2 months).Result Of 37 original HCC leisions, 16 leisions were hyperintense , 4 leisions were isointense, 17 were hypointense in T₁WI . 21 leisions were hyperintense, 5 leisions were isointense, 11 were hypointense in T₂WI. After contrast scanning,21 of the 37 leisions enhanced on artery-phrase dynamic scanning, 5 leisions enhanced on delayed-phrase ,no enhancement were found in the other 11 leisions. On the early-phrase dynamic contrast scanning (artery-phrase) , area of enhancement cooresponding to residual viable tumor,and area of no enhancement corresponding to necrosis. In which the area of permanent enhancement on delayed-phrase dynamic scanning, residual viable tumor or inflammatory infiltration were found. 21 leisions with residual viable tumor were found and 16 leisions with coagulate necrosis were significant found on MRI images. Only 2 fibre envelopes are shown in the residual viable tumors and rate of display is 9.52%. 11 fibre envelopes are shown in the necrosis leisions and rate of display is 68.7%. In contrast to DSA and clinical follow-up, The sensitivity, specificity,and accuracy of MRI were 91.3%, 100%, and 94.6%. There are no...