GIÁ TRỊ CỦA CẮT LỚP VI TÍNH TƯỚI MÁU TRONG ĐÁNH GIÁ HIỆU QUẢ NÚT ĐỘNG MẠCH GAN HÓA CHẤT Ở BỆNH NHÂN UNG THƯ BIỂU MÔ TẾ BÀO GAN

Abstract

Objectives: To assess the diagnostic role of multi-detector computed tomographic perfusion in evaluating the therapeutic response of trans-arterial chemo-embolization in hepatocellular carcinoma. Patients & methods: This study included 15 patients with 20 lesions post-transarterial chemoembolization HCC patients underwent follow-up by hepatic CT perfusion, perfusion parameters {Hepatic arterial blood flow (HABF) & hepatic arterial faction (HAF)} were measured in the hypervascular area of the treated lesion at perfusion color map suspected as residual disease and adjacent hepatic parenchyma to assess therapeutic efficacy. Parameter distribution was described by their quartile values and statistically analyzed. Results: Among 15 patients with 20 lesions. The residual lesion was observed in 13 lesions of the 20 lesions with increased HAF (%) and HABF (ml/min/100 ml) in the residual disease compared to surrounding liver parenchyma with P value < 0.05. The calculated parameters in the residual disease: HABF was 180.40 ± 62.65, & HAF was 54.20 ± 12.53. The calculated parameters in surrounding liver parenchyma: was HABF was 6.01 ± 7.64 & HAF was 6.32 ± 9.92. The residual disease which the cut-off point HABF was 93.42 with sensitivity of 91.7%, specificity of 100%, positive predictive value of 100%, negative predictive value of 80% and the cut-off point HAF was 41.7 with sensitivity 83.3%, specificity 87.5%, positive predictive value 100%, negative predictive value 66.67%. Conclusions: CT perfusion evaluates treatment response in TACE treated HCC patients by providing a quantitative assessment of vascularization of residual tumor.