SERIAL HEMODYNAMIC MEASUREMENTS IN WELL-DIFFERENTIATED HEPATOCELLULARCARCINOMAS

We performed serial hemodynamics in 15 patients with 21 well-different iated hepatocellular carcinomas. The total length of the observation p eriod ranged from 129 to 678 days (median, 368). We investigated both arterial and portal blood how at intervals of at least 4 months. Arter ial blood how was measured with carbon dioxide-enhanced ultrasonograph y (US), and portal blood flow was measured with computed tomographic a rterial portography (CTAP), None of the tumors were hypervascular on t he initial study; however, by the final study nine nodules (42.9%) had become homogeneously hypervascular, two (9.5%) had become partially h ypervascular, and the others did not change. Of 10 nodules without por tal blood supply on any study, 8 became hypervascular by the final stu dy. Of 11 nodules with portal blood supply on the initial study, a fol low-up study showed no change in portal flow in 6 and the loss of port al how in 5. Four of these five became hypervascular, with a documente d loss of portal flow before the increase in arterial flow. The doubli ng time of tumors with a homogeneous increase in arterial blood flow r anged from 89 to 333 days (median, 172), whereas the doubling time of other tumors ranged from 227 to 607 days (median, 392). Thus, growth r ate and vascularity in well-differentiated hepatocellular carcinoma ar e closely correlated. When the well-differentiated hepatocellular carc inoma has portal blood flow and is not hypervascular, it grows slowly, On the other hand, when it loses portal blood flow and becomes hyperv ascular, it grows rapidly.