Hepatic Arteriography Manifestations in Hepatocellular Carcinoma after CT-guided Percutaneous Microwave Coagulation Therapy

Objective:To assess the digital subtraction angiography (DSA) manifestations and its clinical significance in patients with primary hepatic carcinoma after percutaneous microwave coagulation therapy (PMCT).Methods:A total of 12 cases with solitary primary hepatic carcinoma,with the diameter ranged 3.0~6.5cm (mean=4.4cm) were treated with PMCT.DSA of common hepatic artery and super-selective arteriography of suspected area with feeding artery were performed 1~3 months afterwards for follow-up,any tumor remains or recurrence was treated with embolization.Results:The DSA appearances of the area after PMCT were as follows:round shape area with no contrast dyeing or low density dyeing;at the edge of PMCT,granulation (7 cases),hemorrhage (3 cases),tumor remains or recurrence at the margin of lesion (7 cases),no abnormality (2 cases) could be revealed.There were tumor recurrence in the liver other than the primary area (7 cases),the DSA appearances were the same as those of the primary tumor.Marginal recurrence of the primary tumor was found in 12 patients or/and intra-hepatic recurrence in 8 patients,all of them had embolization therapy done.Conclusion:Recognition of the features of tumor margin after microwave coagulation therapy is the key-point for the detection and diagnosis of local tumor remains and/or recurrence,DSA had important clinical significance in the follow-up of treatment effect as well as in the planning of further comprehensive therapy.