Application of color-coded DSA in quantitatively analyzing perfusion decrease of hepatic tumors before and after TACE / 介入放射学杂志

ABSTRACT

Objective To discuss the application of color-coded digital subtraction angiography (ccDSA) in quantitatively analyzing the instant perfusion changes of hepatic tumors during transcatheter arterial chemoembolization (TACE).Methods The clinical data of 35 patients with hepatocellular carcinoma (HCC) who underwent TACE were reviewed.Before and after TACE,two-dimensional DSA (2D-DSA) was performed by using the same parameters in all patients.The image sequences were post-processed with 2D-ccDSA.On ccDSA images the regions of interest (ROIs) were measured to obtain the time-contrast-intensity (CI[t]) curves as well as the perfusion parameters,including tumor blood supply time (TBST),area under the curve (AUC),contrast-intensity peak (C I-Peak) and maximum upslope (MS),which were used to evaluate the degree of the reduction in direct blood flow and in tumor staining.The relationship between the above parameters and subjective angiographic chemoembolization endpoint (SACE) was analyzed.Results After TACE,the perfusion parameters were significantly different from pre-TACE ones.AUC and CI-Peak values were dramatically decreased.After TACE,TBST slowed a significant delay.The reduction of perfusion about 30％-40％ was equal to SACE grade Ⅲ;the reduction of perfusion about 60％-70％ was equal to SACE grade Ⅳ.Conclusion 2D-ccDSA can be used to objectively and quantitatively evaluate the effect of TACE on the perfusion of hepatic tumors,providing useful indexes for making quantitative assessment of the degree of blood flow stagnation and the reduction of tumor staining.