Comparative Study On CT And DSA Follow-up Of Primary Hepato-Carcinoma After Transcatheter Arterial Chemoembolization

Objective:To compare the value of CT and DSA in evaluating the residual and recurrence of tumor of Primary hepato-carcinoma(PHC) after transcatheter arterial chemoembolization (TACE) with Lipiodol. Methods:45 patients with HPC, Lipiodol deposition shapes of all cases were divided into three types: complete compact, defect and pauciform types.,underwent CT and DSA within 1~6 months after 1~4 procedure(s) of TACE. The interval between the two examinations was controlled as 3~5days, to compare and analyze the patterns of the residual lesion and recurrence of tumor in CT and DSA.Results: complete compact type, 9cases(20%, 9/45)In the patients with complete compact type, no reccurence was found underwent CT and DSA after follow up for six months, defect type, 32cases(71.1%, 32/45), 27 cases had reccurrent underwent DSA, dual-phase CT scanning showed 19 cases reccurrent, In 16 patients dual-phase dynamic contrast–enhancement scan showed significantly enhanced residual and recurrent tumor in the arterial phase. Three cases were further strengthen in portal venous phase (suggesting that there is involvement of the portal vein). DSA found feeding arteries and the tumour staining. In another 8 cases of no enhancement was detected by dual-phase enhancement scan, whereas DSA demonstrated the blood supply of tumors and tumor staining; In 4 cases of pauciform types (8.9%,4/45)all of them were found reccurrencet ,dual-phase enhanced CT showed slight enhancing, and DSA showed less blood supply. In 9 cases of PHC, information of tumor assoelated with portal vein tumor thrornbi in the main trunk and proximal branohes was provzded byDSA. When takingDSA asgolden standard, the tactay of dual-phase enhanced CT was70.73%. However, in these9eases, apart from the above-mentioned tumor thrombi in the major portal veins additional turnor thrombus with in peripheral portal vein were deteeted by CT in 6 cases, P=0.031<0.05. Conclusion:Plain and dual-phase CT scanning are the commonest imaging modality in the follow-up of HPCs treated by TACE, But it is still difficult to evaluation overall by CT due to it's limitations; DSA is the most sensitive and specific method to observe and evaluate the change of the tumor, combination can be better displayed the lesions on the follow-up to better guide treatment.