原发性和转移性肝癌的彩色多普勒血流显像分析

目的　探讨彩色多普勒血流显像 (CDFI)在检测原发性和转移性肝癌中的应用 ,为诊断和鉴别诊断提供依据。方法　应用CDFI观察原发性肝癌 47例 ,转移性肝癌 3 2例 ,观察肿块及肝动脉、门静脉的血流情况 ,用脉冲多普勒测量肿块内动脉及肝动脉的收缩期最大血流速度、阻力指数、搏动指数、收缩期峰值与舒张末期血流速度之比及血流量、门静脉的收缩期最大血流速度及血流量并进行对比分析。结果　原发性和转移性肝癌两组病例中≤ 3cm的肿块血流以 0级和Ⅰ级为主 ;原发性肝癌中 >3cm的肿块血流以Ⅱ级和Ⅲ级为主 ;转移性肝癌中 >3cm的肿块血流以Ⅰ级和Ⅱ级为主 ,以瘤周供血为特点 ;原发性肝癌的血流呈高速高阻型。结论　原发性和转移性肝癌有不同的彩色多普勒血流表现 ,CDFI有助于两者的诊断和鉴别诊断。

Study on color Doppler blood flow characteristics of primary and secondary hepatic tumors

Objective Patterns of hemodynamics changes of hepatocelluler carcinoma(HCC) and metastatic hepatic cancer(MHC)were analysed by color Doppler imaging(CDFI)to provide evidences for diagnosis and differential diagnosis.Methods forty-seven patients with HCC,thirty-two patients with MHC and thirty-five normal adults were studied with CDFI as well as the hemodynamic changes of hepatic artery and portal vein.The measurement indexs were the maximum blood flow velocity(Vmax),the resistant index(RI),the pulsatility index(PI),the ratio of the maximum to minimum blood flow velocity(A/B) and the blood flow volume(FV)Results The tumor which diameter≤3cm were not hypervascular,most of their blood flow type were class 0 and Ⅰ.Among the tumor of diameter>3cm,most of HCC group's blood flow type were classⅡand Ⅲ,and MHC group's were classⅠand Ⅱ.The lesions of MHC showed mainly periphery flow pattern around tumor.The Vmax and RI of HCC were higher than that in control group.Conclusion There are significant differences between the patterns of hemodynamic changes in HCC and MHC.CDFI plays an important role in the diagnosis and differential diagnosis of HCC and MHC.