The Value Of Contrast-enhanced CT During The Operation In Thermal Ablation Of Liver Malignant Tumors

Aims To evaluate the efficiency and safety of contrast-enhanced CT during the operation in thermal ablation of liver malignant tumors compared with non-contrast enhanced CT-guided thermal ablation.Methods From July 2017 to December 2017,a total of 64 patients with liver malignant tumors received CT-guided thermal ablation(including radiofrequency ablation(RFA)and microwave ablation(MWA))in our hospital,35 patients with contrast-enhanced CT-guided thermal ablation and the remaining 29 patients with non-contrast enhanced CT-guided thermal ablation.In the contrast-enhanced CT group,there were 51 lesions in 35 patients,23 lesions in 15 patients were treated with RFA and 28 lesions in 20 patients were treated with MWA.In the non-contrast enhanced CT group,there were 40 lesions in 29 patients,18 lesions in 13 patients were treated with RFA and 22 lesions in 16 patients were treated with MWA.Hepatic dynamic contrast-enhanced MR imaging was obtained 1 month and 3 months after the operation to evaluate the residual tumors and complications between contrast-enhanced CT group and non-contrast enhanced CT group.Results In the contrast-enhanced CT group,contrast-enhanced CT immediate assessment found residual tumors in 5 lesions,which subsequently received supplementary ablation during the operation.49 lesions had complete ablation(96.1%,49/51)and 2 lesions had residual tumors(3.9%,2/51)in the contrast-enhanced CT group,32 lesions had complete ablation(80.0%,32/40),8 lesions had residual tumors(20.0%,8/40)in the non-contrast enhanced CT group,which were confirmed by hepatic dynamic contrast-enhanced MR imaging 1 month and 3 months after the operation,and there was statistical difference in the occurrence of residual tumors between these two groups(P<0.05).Minor complications occurred in 21 patients(21/35,60.0%),major complication occurred in 1 patient(1/35,2.9%)in the contrast-enhanced CT group.Minor complications occurred in 23 patients(23/29,79.3%),major complications occurred in 3 patients(3/29,10.3%)in the non-contrast enhanced CT group.There was no statistical difference in the occurrence of minor or major complications between these two groups(both P>0.05).Conclusions Compared with non-contrast enhanced CT-guided thermal ablation,contrast-enhanced CT-guided thermal ablation could lower the occurrence of residual tumors after the operation,thus it has high clinical application value and is worth of being generalized.Further studies are still mandatory.