[Blood supply of liver metastasis].
OBJECTIVE
To probe the blood supply of liver metastasis by celiac arteriography, proper hepatic arteriogaphy, pure portal vein perfusion CT.


METHODS
Fifty patients with liver metastasis were examined prospectively by plain CT scan, multiphase enhanced CT scan, celiac arteriography and proper hepatic arteriography, of whom, 23 were examined by pure portal vein perfusion CT during superior mesenteric arterial portography. The imaging manifestations were observed, and the time attenuation curves (TDC)of tumor center, tumor edge, portal vein and normal liver parenchyma were used to calculate liver perfusion with a software of PhotoShop(used in DSA image analysis)and a deconvolution model (CT perfusion software) designed for the dual blood supply.


RESULTS
DSA findings: hypervascular 12 cases, hypovascular 38 cases, and ring tumor stain 36 cases. TDC of proper hepatic arteriography showed: the mean peak concentration (K value) in tumor center (67.48+/-11.56)%, the mean peak concentration (K value) on tumor edge (76.23 +/-14.89)%, the mean peak concentration (K value) in normal liver parenchyma (51.42+/-10.26)%; the mean time to peak concentration in tumor center(9.00+/- 1.03) s, and the mean time to peak concentration on tumor edge (10.69+/-2.82) s; TDC of celiac arteriogaphy showed: the concentration of tumor center and tumor edge increased fastly in early stage, then maintained an increasing plateau slowly, in the meanwhile, the concentration of normal liver parenchyma increased slowly and steadily, after 14 s of acquisition, the concentration of tumor center was lower than that of tumor edge and normal liver parenchyma. Mean time to peak concentration of portal vein was(11.84+/-1.81) s. Multiphase enhanced CT scan findings: ring enhancement in artery phase 11 cases; mild ring enhancement in artery phase,continued thick ring enhancement in portal phase 5 cases; no enhancement in artery phase,ring enhancement in portal phase 25 cases; ring enhancement in equilibrium phase 8 cases; no enhancement in artery phase, portal phase and equilibrium phase 1 case. The mean time to peak enhancement of portal vein was(14.33+/-2.23) s, and the mean enhancement peak value (320.00+/-28.78) HU; the densily of normal liver parenchyma increased slowly after contrast medium administration, the mean time to peak enhancement was (22.25+/-3.44) s, and the mean enhancement peak value (110.75+/-16.31) HU.


CONCLUSIONS
The blood supply of liver metastasis only comes from hepatic artery, and portal vein does not join in the blood supply of liver metastasis.
Li
Zhi gang
Zg
Departmet of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China. zhigangli9@yahoo.com.cn
Huang
Jing xiang
Jx
Li
Shun zong
Sz
Zhao
Jun jing
Jj
Shi
Gao feng
Gf
Liang
Guo qing
Gq
Wang
Hong guang
Hg
Han
Peng yin
Py
Wang
Qi
Q
Gu
Tie shu
Ts
D000368:Aged; D002445:Celiac Artery / Q000000981:diagnostic imaging; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000556:secondary*; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed