Assessment of tumor hemodynamics in small hepatocellular carcinoma: comparison of Doppler ultrasonography, angiography-assisted computed tomography, and pathological findings.
OBJECTIVE
We evaluated the usefulness of Doppler ultrasonography (DUS) for the analysis of tumor hemodynamics in small hepatocellular carcinoma (HCC).


METHODS
We compared Doppler ultrasound (DUS) findings with angiography-assisted computed tomography (Angio-CT) such as CT during arterial portography and during hepatic arteriography in the evaluation of the intratumoral hemodynamics, and with pathologic findings in 45 small HCC nodules (< or =3.0 cm in diameter) of 43 patients. DUS flow pattern of each nodule was categorized into three types: afferent continuous flow (Type 1), afferent pulsatile flow with afferent continuous flow (Type 2), and afferent pulsatile flow without afferent continuous flow (Type 3). Intratumoral blood supply was determined by Angio-CT, and pathologic findings were evaluated on resected or biopsied specimen.


RESULTS
Based on Angio-CT findings, Type 1 nodules showed decreased arterial blood supply (ABS) without decreased portal blood supply (PBS). Type 2 nodules showed unchanged ABS but decreased PBS. Type 3 nodules showed both increased ABS and decreased PBS. DUS findings well represented blood supply of HCC evaluated by Angio-CT. In addition, all Type 1 and 2 nodules were well-differentiated HCC, and all Type 3 nodules were moderately or poorly differentiated HCC; DUS findings well reflected differentiation of HCC.


CONCLUSIONS
DUS is a non-invasive imaging method and can be used for the evaluation of the stage of malignancy of small HCC.
Kumada
Takashi
T
Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu 503-8502, Japan. tkumada@he.mirai.ne.jp
Nakano
Satoshi
S
Toyoda
Hidenori
H
Hayashi
Kazuhiko
K
Kiriyama
Seiki
S
Sone
Yasuhiro
Y
Tanikawa
Makoto
M
Hisanaga
Yasuhiro
Y
Yamamoto
Akiko
A
Takeshima
Kenji
K
Hibi
Toshio
T
Yabashi
Toshitake
T
Noda
Takahiro
T
Sassa
Toshi
T
Furukawa
Masakazu
M
Ogawa
Sadanobu
S
D000368:Aged; D000792:Angiography; D001783:Blood Flow Velocity; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006499:Hepatic Artery / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color