肝癌肝动脉血流动力学变化的彩色多普勒超声检测

Hepatic Arterial Henodynamic Detected with Duplex Doppler Sonography in Hepatocellular Carcinoma

目的：了解供应肝癌的肝动脉分支与非供应肝癌肝动脉分支的血流动力学差异。材料与方法：用脉冲多普勒超声对４９例肝脏某一叶的单发性肝癌及３８例慢性肝病患者进行检查，分别测量左、右肝动脉分支多普勒速度频谱角度矫正的峰值血流速度（ＰＳ）及搏动指数（ＰＩ）。结果：在慢性肝病组，左、右肝动脉分支峰值血流速度及搏动指数无显著差异，而３ｃｍ以上肝癌，供癌肝动脉分支比非供癌肝动脉分支，峰值血流速度明显升高，搏动指数明显降低，血流动力学变化程度与肝癌大小及门静脉内有无癌栓有关。结论：供应肝癌的肝动脉分支较非供应肝癌的肝动脉分支阻力降低。

Purpose: To study the hemodynamic differences between the hepatic arterial branches that supply hepatocellar carcinoma (HCC) and those do not, we compared the velocity waveforns in both types of arteries. Materials and Methods: 49 patients with single HCC and 38 patients with chronic liver disease were examined, using duplex doppler sonography. We measured angle-corrected peak sys tolic velocity (PS) and the pulsatility index (P1) of left and right hepatic arteries. Results: There was no significant difference in PS and P1 between left and right hepatic arteries in chronic liver disease group. We found a significantly lower P1 and a significantly higher PS in the arterial branches supplying the tumor than that in those do not supply tumor in patients with HCC 3cm or larger in diameter. The degree of hemodynamic changes correlated with the tumor size and the tumor thrombus of the portal vein. Conclusions: Our results showed that the hepatic arterial branch supplying HCC has lower impedance than the branch not related to HCC.