Multidetector CT in evaluating blood supply of hepatocellular carcinoma after transcatheter arterial chemoembolization.

Abstract

To assess the value of multidetector-row computed tomography (MDCT) in choosing retreatment methods of hepatocellular carcinoma (HCC) through evaluating the blood supply of low-density area of HCC after transcatheter arterial chemoembolization (TACE). Thirty-two patients with HCC after TACE treatment were examined by plain scanning and hepatic multidetector-row CT. The location of low-density area on plain scanning and the enhancement patterns on dynamic contrast-enhanced scanning were observed. At the same time, three-dimensional CT (3D CT) models of the volume rendering, curved multiplanar reformations, surface shaded display and maximum intensity projection reconstruction of the hepatic artery and portal vein were performed in 6 cases. In CT plain scanning data, low density areas of 32 cases of HCC after TACE treatment were divided into three types: peripheral, one-side-located and mixed types. In contrast-enhanced CT scans, the blood supply of low-density area was classified into four types: arterial blood supply (20 cases), portal blood supply (5 cases), arterial combined with portal blood supply (5 cases) and poor blood supply (2 cases). In 6 cases, the relationship between the low-density area and branches of hepatic artery as well as portal vein was shown by 3D CT. Hepatic MDCT is an effective method for evaluating the blood supply of low-density area and therapeutic effect of HCC after TACE treatment. Types of blood supply is helpful for the selection of retreatment.