Analysis of blood flow in hepatic tumors by color doppler ultrasonography

We evaluated the diagnostic significance of blood flow pattern and velocity in hepatic tumors detected by color doppler ultrasonography. Fiftyseven patients with hepatocellular carcinoma (HCC) and 12 patients with hepatic hemangioma (HEM) were studied with ultrasonographic apparatus equipped with color doppler system (Toshiba SSA-270A, 3.75MHz sector scanner). Furthermore 12 patients with HCC were studied repeatedly after transcatheter arterial embolization (TAE) and/or percutaneous ethanol injection (PEI). Blood flow was measurable in 2 of 12 patients with HEM (17%). Pulsatile flow with low speed (7 cm/sec) and low amplitude was detected in one patient, and continuous flow with low speed (5 cm/sec) in the other. Blood flow was measurable in 43 of 57 patients with HCC (75%). The detection rate of blood flow in HCC was significantly higher than in HEM. Pulsatile flow was detectable in 42 of 43 patients (98%). Average maximum velocity of pulsatile flow was over 40cm/sec. Analysis of blood flow after treatment provided us useful information on the effect of treatment. In conclusion, analysis of blood flow in hepatic tumors on US with color doppler system may provide useful information on differential diagnosis between HCC and HEM, the assessment of the therapeutic effect of TAE or PEI, whether additional treatment is required or not, and when it should be done if required.