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目的:为了探知向肝细胞癌供血与不供血的肝动脉分支间的血液动力学差异,对该两类动脉的速率波形作了比较。方法:利用双联彩色多普勒超声检查了38例单个肝叶内有肝细胞癌的患者和34例慢性肝病但无肝细胞癌的患者(对照者)。沿着右前段肝门分支和左侧肝门静脉垂直段测量了彩色编码的肝动脉校正角的收缩速率峰值与搏动指数。结果:对照组测试的动脉分支间的收缩速率峰值与搏动指数均无显著性差异,相反地,在肝细胞癌(直径≤3cm)患者中,向肿瘤供血的动脉分支搏动指数显著低于不向肿瘤供血的动脉分支。而收缩速率峰值却显著高于后者(P<0.05)。这些血液动力学改变的程度与肿瘤的大小及大的肝门动脉分支中有无瘤栓的存在有关。结果:这些结果表明,向肝细胞癌供血的肝动脉分支阻力低于不向肿瘤供血的分支。
OBJECTIVE: To determine the hemodynamic differences between hepatic arterial blood supply and non-blood supply hepatic artery branches, the rate waveforms of the two types of arteries were compared. METHODS: Twenty-eight patients with hepatocellular carcinoma in a single liver lobe and 34 patients with chronic liver disease but no hepatocellular carcinoma (control) were examined using duplex color Doppler ultrasound. The peak value of the contraction rate and the pulsatility index of the color-coded hepatic artery correction angle were measured along the right anterior segment of the hilar and the vertical segment of the left hepatic portal vein. RESULTS: There was no significant difference in the peak contraction rate between the arterial branches measured by the control group and the pulsatility index. Conversely, in patients with hepatocellular carcinoma (diameter ≤ 3 cm), the pulse index of the arterial branches supplying tumors was significantly lower than that of the pulsatility index. The arterial branch of the blood supply to the tumor. The peak contraction rate was significantly higher than the latter (P < 0.05). The extent of these hemodynamic changes is related to the size of the tumor and the presence of a tumor thrombus in the large hepatic portal artery branch. RESULTS: These results indicate that the hepatic artery branching resistance to hepatocellular carcinoma is less than that of the branch that does not provide blood to the tumor.