原发性和转移性肝癌肿块及肝脏的血流动力学变化

目的：了解原发性肝癌（HCC）的转移性肝癌（MHC）肿块及肝脏的彩色多普勒超声表现，为其诊断和鉴别诊断提供依据，方法：彩色多普勒血流显像（CDFI）观察183个HCC肿块，96个MHC肿块，及其肝动脉，门静脉的血流情况，分别检测其最大血流速度（vmax)和阻力指数（RI），将两组资料分别分为小肝癌型，结节型及块状型进行对比分析，结果：随着肿块增大，两组肿块增大而增加，HCC以瘤内双重供血为主，vmax和RI均随肿块增大而增高，MHC以瘤周双重供血为主，随肿块增大PI增高，三型肿块vmax均为30cm.s^-1左右，随肿块增大无明显增加，HCC组RI无明显变化，MHC组RI随之增大，HCC组门静脉内径和vmax随肿块增大无显著变化，而MHC组内径增加，vmax却逐渐降低，结论：原发性与转移性肝癌的肿块和肝脏血流动力学表现明为不同，CDFI对两者的诊断及鉴别诊断具有重要作用。

Hemodynamic changes of liver with primary and secondary tumors using color Doppler ultrasonography

AIM　Characteristics of hemodynamics for hepatocelluler carcino ma (HCC) and metastatic hepatic cancer (MHC) using color Doppler flowing imaging (CDFI) of were analysed to tender for diagnosis and differential diagnosis evide nces. METHODS　183 tumors with HCC and 96 tumors with MHC were s tudied using CDF I, as well as the hemodynamic changes of hepatic artery and portal vein. The max imum blood flow velocity (vmax) (the peak systolic flow velocity) and the resist ant index (RI) were measured. Tumors were classified into three types: Small li ver cancer, node liver cancer and lump liver cancer. All the measurements were c ompared among them. RESULTS　The larger the diameter of tumor, t he richer the bl ood flow. In HCC combined pattern predominated in introtumor blood flow, which V max and RI increased with the enlargement of tumor.As to MHC combined pattern pr edominated in peritumor blood flow, which RI increased accordingly. All the v max of three types in MHC were 30 cm*s-1 without significant differences（ P>0.0 5）. The hepatic artery diameter and vmax increased accordingly in b oth groups, s o di d RI in MHC but in HCC. The diameter of portal vein and its vmax remai ne d in HCC group but reduced in MHC group. CONCLUSION　There are significant differences b etween the patterns of hemodynamic changes of masses and livers in HCC and those of in MHC. CDFI is important for the diagnosis and differential diagnosis of HC C and MHC.