CHANGE IN HEPATIC ARTERIAL HEMODYNAMICS INDUCED BY HEPATOCELLULAR-CARCINOMA DETECTED WITH DOPPLER SONOGRAPHY

Purpose. To understand the hemodynamic differences between the hepatic arterial branches that supply hepatocellular carcinomas (HCCs) and th ose that do not, we compared the velocity waveforms of both types of a rteries. Methods. Using duplex color Doppler sonography, we examined 3 8 patients with HCC localized within a single lobe of the liver and 34 patients with chronic liver disease but without HCC (controls). We me asured angle-corrected peak systolic velocity and the pulsatility inde x (PI) of color-coded hepatic arteries along the right anterior segmen tal portal branch and the vertical segment of the left portal vein. Re sults. There was no significant difference in peak systolic velocity a nd PI between the arterial branches tested in the controls. In contras t, we found a significantly lower PI and a higher peak systolic veloci ty in the arterial branches supplying the tumor than in those not supp lying the tumor in patients with an HCC 3 cm or larger in diameter (p < 0.05). The degree of these hemodynamic changes correlated with the t umor size and the presence or absence of tumor thrombus in the major p ortal branches. Conclusions. These results indicate that the hepatic a rterial branch supplying an HCC has a lower impedance than the branch not supplying the tumor. (C) 1997 John Wiley & Sons, Inc.