A Comparative Study Of The Effect Of CT On The Efficacy Of TACE In The Treatment Of Primary Liver Cancer And Conventional CT

Object: To investigate the application value of CT in the early evaluation of the therapeutic effect of transcatheter arterial chemoembolization in patients with primary liver cancer,and to compare the accuracy of the conventional CT with that of conventional chemotherapy.Methods: 1.From December 2015 to May 2016 were diagnosed in the First Affiliated Hospital of Xinjiang Medical College of Shihezi University for 39 cases of primary liver cancer and preparing for the second TACE treated patients,all patients signed the informed consent to TACE treatment,and preoperative 1~3 days were spectrum CT and conventional CT examination,and were confirmed by DSA male;35 cases(89.7%),4(10.3%)cases of female,aged 42~79 years old,average age(55.4 + 11.1).2.Scanning equipment using the United States GE company Discovery HD 750 CT scanner and GSI Liver scan sequence.3.The collected CT image and spectral CT image to GE adw4.6 workstation,and reconstruct the thickness of 1.25 mm plain and 3 phase(arterial phase and portal venous phase and delayed phase)iodine based image;5 selected region of interest image each time at the level of tumor embolism different on region of interest(ROI),to include the entire lesion area should choose ROI tumor and non tumor area selection of ROI should be avoided as far as possible blood vessels,biliary tract,artifacts.Then measurement of the tumor and non tumor areas of iodine based image on the concentration of iodine content,and conventional CT image CT value;the tumor IC lesion as the concentration of iodine content of iodine content in iodine concentration concentration enhanced flat content scan measurement scan measurement of the 3 period,content of iodine concentration in the area of non tumor IC the liver concentration of iodine content of each period surrounding normal liver tissue.TACE before and after the measurement of the parameters of the same method,the location of the selected ROI,size,pixels are basically the same.4.The data were analyzed by SPSS 17 statistical software,using statistical methods for diagnostic tests,by comparing the energy spectrum of CT and conventional CT with the gold standard of DSA,the number of cases were true positive,true negative,false positive,false negative,two methods of calculating respectively the sensitivity and specificity,the rate of missed diagnosis and misdiagnosis rate.The diagnosis indexROC curve the inspection efficiency through the area under the curve to compare the two.Results: 1.39 patients with HCC were satisfied with routine CT,multi-energy CT and DSA images.2.Multi-energy CT analysis: CT judgment result by DSA as the "gold standard",the sensitivity of CT spectroscopy to determine whether there is residual or recurrent tumor was 96.77%,the specificity was 100%,the misdiagnosis rate was 0%,the misdiagnosis rate was 3.23%,the diagnostic index was 196.77%.3.The conventional CT judgment result analysis: using DSA as the "gold standard",the sensitivity of conventional CT to determine whether there is residual or recurrent tumor was 67.74%,the specificity was 100%,the misdiagnosis rate was 0%,the misdiagnosis rate was 32.26%,the diagnostic index was 167.74%.4.The ROC curve shows that the area under the curve of CT can be 0.984,and the area under the curve of the conventional CT is 0.839,which shows that the test efficiency of the energy spectrum CT is higher than that of the conventional CT.Conclusion: 1.The content of iodine spectrum CT iodine kitu on intrahepatic small lesion detection sensitivity is high,has an important reference value for the evaluation of curative effect after TACE.2.The content of iodine spectrum CT iodine kitu on intrahepatic small lesion detection sensitivity is high,has an important reference value for the evaluation of curative effect after TACE.3.Evaluation and guidance of multi parameter imaging of multi-energy CT and TACE in the treatment of primary hepatocellular carcinoma reintervention timing can provide the image data more detailed,more accurate and more comprehensive,is a more reliable method of assessment;for clinicians in the follow-up treatment plan making and prognosis are the guide a certain role.