肝癌门静脉癌栓及其血流动力学的彩色多普勒研究

原发性肝癌（ＨＣＣ）具有侵蚀周邻血管的特性，常常侵及门静脉及肝静脉系统，尤以前者多见，可引起动静脉分流，造成门静脉血流方向的紊乱或逆流。本文对１０例ＨＣＣ伴门静脉癌桂的患者进行了彩色多普勒血流显像（ＣＤＦＩ）检查，并均行血管造影。结果表明，ＣＤＦＩ可清晰地显示出静脉癌栓及其血供状态和门静脉血流方向的变化。其特征表现为：①门静脉管腔内见动脉样频谱；②门静脉原向肝的血流变为离肝的血流。上述结果与血管造影符合率为９０％。因此，ＣＤＦＩ对ＨＣＣ的分级和治疗方法的选择具有重要的意义。

An Observation of Hemodymamics and Tumor Thrombus of the Portal Vein with Color Doppler Ultrasound

One of the hallmarks of hepatocellular carcinoma(HCC) is its propensity to invade abjacent vasculature,specifically invading portal vein or hepatic veins. Formation of arteriovenous shunt due to portal vein being invaded can cause its hemodynamic alteration. Color Doppler flow Imaging (CDFI)examination and angiography were performed in 10 patients with portal-vein-tumor thrombus. The results show that CDFI can acurately identify portal-vein-tumor thrombus, blood supply of the carcinoma and blood flow direction of the portal vein. The CDFI signals are: (1)an arterial waveform is detected within the vein; (2)The direction of frow changed frow hepatopetal to hepatofugal. Coincidental rate of CDFI and angiography findings is as high as 90%. Therefore,we consider that CDFI is of importance to HCC grade and selection of therapeutic methods.