Flow characteristics of hepatic tumors at color Doppler sonography: correlation with arteriographic findings

Abstract

Objective: We studied benign and malignant hepatic tumors with color Doppler sonography and arteriography in order to correlate color Doppler flow characteristics with tumor hemodynamics (vascularity, arteriovenous shunting, and portal vein involvement) shown by arteriography. We also evaluated the usefulness of color Doppler flow characteristics in discriminating between tumor types.

Subjects and methods: We performed color Doppler sonography and hepatic arteriography in 58 patients with 72 hepatic lesions larger than 2.0 cm in diameter. Differences in pulsatile flow (peritumoral or intratumoral) and the highest systolic peak flow velocities reached were evaluated on color Doppler sonograms and compared with arteriographic findings.

Results: Color flow sonograms were obtained in 43 of 45 hepatocellular carcinomas, 15 of 16 cholangiocellular carcinomas or hepatic metastases, and six of 11 hemangiomas. Mixed peritumoral and intratumoral pulsatile flow was shown by arteriography in highly vascular tumors. The mean peak systolic flow velocity seen in hepatocellular carcinomas (0.52 m/sec) significantly exceeded the velocity seen in hemangiomas (0.16 m/sec), but not the velocity seen in other malignant hepatic tumors (0.51 m/sec). Six hepatocellular carcinomas, one cholangiocellular carcinoma, and two hepatic metastases with peak systolic flow velocities greater than 0.80 m/sec were each proved arteriographically to have arteriovenous shunting or portal vein involvement.

Conclusion: Color Doppler sonography was useful for evaluating hepatic tumor hemodynamics as seen at arteriography, and peak systolic velocity may be useful in differentiating malignant hepatic tumors from hemangiomas.