Change in hepatic arterial hemodynamics induced by hepatocellular carcinoma detected with Doppler sonography

PURPOSE: To understand the hemodynamic differences between the hepatic arterial branches that supply hepatocellular carcinomas (HCCs) and those that do not, we compared the velocity waveforms of both types of arteries. METHODS: Using duplex color Doppler sonography, we examined 38 patients with HCC localized within a single lobe of the liver and 34 patients with chronic liver disease but without HCC (controls). We measured angle-corrected peak systolic velocity and the pulsatility index (PI) of color-coded hepatic arteries along the right anterior segmental portal branch and the vertical segment of the left portal vein. RESULTS: There was no significant difference in peak systolic velocity and PI between the arterial branches tested in the controls. In contrast, we found a significantly lower PI and a higher peak systolic velocity in the arterial branches supplying the tumor than in those not supplying the tumor in patients with an HCC 3 cm or larger in diameter (p < 0.05). The degree of these hemodynamic changes correlated with the tumor size and the presence or absence of tumor thrombus in the major portal branches. CONCLUSIONS: These results indicate that the hepatic arterial branch supplying an HCC has a lower impedance than the branch not supplying the tumor.