Arai K
Department of Radiology, Kanazawa University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1992 Mar 25;52(3):320-37.
The value of color duplex Doppler sonography in evaluating tumor vascularity was investigated in 82 hepatic tumors (61 hepatocellular carcinomas, 11 metastatic cancers, eight adenomatous hyperplasia, one focal nodular hyperplasia, and one cholangiocellular carcinoma) receiving angiography, 64 intrahepatic arteries, and five hepatic cysts. The minimum diameter of the intrahepatic arteries (lateral inferior subsegmental arteries) from which signals could be weakly obtained by using a 3.5 MHz transducer was 0.7 mm. Twenty-eight (74%) of 38 tumors with signals within them had definite tumor vessels on angiography, and continuous blood flow within the tumors showed an association with the dilated tumor vessels. Eighteen (69%) of 26 tumors with signals within them receiving conventional angiography had tumor vessels greater than 0.7 mm. However, only 17 (31%) of 55 tumors less than or equal to 3 cm showed signals within them in contrast to 21 (78%) of 27 tumors greater than 3 cm. Three of eight adenomatous hyperplasias, which were angiographically undetected and had portal or hepatic venous branches, showed signals within them. Four tumors that had abnormally high velocity arterial signals (greater than 0.63 m/sec) within them showed no arteriovenous shunt. Evaluation of tumor vascularity according to the Doppler sonographic findings at the periphery of the tumor was difficult. This was attributed to the fact that the real sample volume was larger than that on B-mode image, with no correlation seen between the signals at the tumor periphery or the existence of arteries surrounding the tumor and tumor vascularity. Although a correlation was seen between tumor vascularity or tumor size and peak systolic velocity determined at the tumor periphery (p less than 0.05), five of six tumors with abnormally high velocities (greater than 0.63 m/sec) at the tumor periphery were greater than or equal to 5 cm in diameter. Doppler signals of the artery feeding the arteriovenous shunt were characterized by abnormally high velocity and low resistive index. In conclusion, Doppler sonography is somewhat useful in evaluating tumor vascularity, but less so in small hepatic tumors.
对82例接受血管造影的肝肿瘤（61例肝细胞癌、11例转移癌、8例腺瘤样增生、1例局灶性结节增生和1例胆管细胞癌）、64条肝内动脉和5个肝囊肿进行了彩色双功多普勒超声检查，以评估肿瘤血管情况。使用3.5MHz换能器能微弱获取信号的肝内动脉（外侧下亚段动脉）的最小直径为0.7mm。38例内部有信号的肿瘤中，28例（74%）在血管造影时有明确的肿瘤血管，肿瘤内的持续血流与扩张的肿瘤血管相关。26例接受传统血管造影且内部有信号的肿瘤中，18例（69%）的肿瘤血管大于0.7mm。然而，直径小于或等于3cm的55例肿瘤中只有17例（31%）内部有信号，而直径大于3cm的27例肿瘤中有21例（78%）内部有信号。8例腺瘤样增生中有3例血管造影未检测到且有门静脉或肝静脉分支，其内部有信号。4例内部有异常高速动脉信号（大于0.63m/秒）的肿瘤未显示动静脉分流。根据肿瘤周边的多普勒超声检查结果评估肿瘤血管情况很困难。这归因于实际样本体积大于B模式图像上的样本体积，肿瘤周边的信号或肿瘤周围动脉的存在与肿瘤血管情况之间无相关性。尽管肿瘤血管情况或肿瘤大小与在肿瘤周边测定的收缩期峰值速度之间存在相关性（p小于0.05），但肿瘤周边速度异常高（大于0.63m/秒）的6例肿瘤中有5例直径大于或等于5cm。为动静脉分流供血的动脉的多普勒信号特征为速度异常高和阻力指数低。总之，多普勒超声在评估肿瘤血管情况方面有一定作用，但对小肝肿瘤的作用较小。
