[Hemodynamic changes in patients with colorectal adenocarcinoma: the role of color Doppler US].
BACKGROUND
Color Doppler US was used to study splanchnic hemodynamic changes in colorectal adenocarcinoma patients. The accuracy of the Doppler perfusion index (DPI) was also investigated. DPI measurements can provide precious information on the degree of hepatic circle arterialization and especially the early evidence of liver metastases which were previously undetected because they were below the resolution threshold of the other imaging techniques.


METHODS
Sixty patients were divided into 3 groups: a control group of 20 patients with negative laboratory and instrumental findings; a group of 20 patients with colorectal adenocarcinoma but no liver metastases; a group of 20 patients with liver metastases from colorectal adenocarcinoma. The patients were submitted to color flowmetry of the liver and splanchnic vessels following a strictly standardized protocol.


RESULTS
The DPI values were < 0.25 on all the controls and > 0.50 +/- 0.15 in the patients with liver metastases. The DPI values matched those of the controls in one third of the patients with a primary colorectal adenocarcinoma but no metastases and were > 0.30 in the remaining two thirds--though never as high as in the patients with liver metastases. A number of patients with DPI > 0.30 exhibited a marked reduction in the caliber and velocimetric profiles of the superior mesenteric artery.


CONCLUSIONS
The DPI was a very sensitive tool for measuring the degree of hepatic circle arterialization and therefore permitted the early detection of liver metastases when they are still below the resolution threshold of the other imaging modalities. The detection of reduced superior mesenteric artery caliber and flow in a number of patients with DPI > 0.30 seems to confirm the controversial hypothesis of the existence of a humoral neoplastic factor in patients with liver metastases from colorectal adenocarcinoma which would induce such changes through a direct or indirect mechanism.
Istituto di Radiologia, Università degli Studi, Catania.
F
F
Pennisi
B
B
Ascanio
R
R
Farina
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000556:secondary; D000293:Adolescent; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D013152:Splanchnic Circulation; D018615:Ultrasonography, Doppler, Color / Q000706:statistics & numerical data