The significance of colour velocity and spectral Doppler ultrasound in the differentiation of liver tumours

Objective: The aim of the work was to develop a standard protocol of colour velocity and spectral Doppler ultrasound (D.-US) of liver tumour vascularization and to estimate the value of this method in differentiation of liver tumours. Methods: In 1994 and 1995, 68 patients with 128 primary and secondary liver tumours were observed. The final diagnosis was histologically verified. The diagnostic system Acuson 128 X/P 10M (Mountain View, CA) with 3.5 MHz convex abdominal probe was used. Qualitative features (vessel presence, vessel location and waveform of tumour vessel blood flow) and quantitative features (vessel quantity per cm 2 , vessel diameter, maximum velocity (V max ), and resistance index (RI) of tumour artery, and V max of tumour portal vein) were included in the D.-US protocol. The differences in these features among various liver tumours were retrospectively analysed. Results: The tumour vascularization was found more frequently in hepatocellular carcinoma (HCC) than in cavernous hemagioma (CavHA) or metastatic liver lesion (MLL) (P < 0.01). Among the tumours with detected vascularization, significant differences (P < 0.01) were found (1) in vessel presence: (a) around tumour between MLL and HCC with or without liver cirrhosis (LC) or CavHA; (b) in periphery of tumour between HCC,CavHA, benign tumour (BT; hepatocellular adenoma, focal nodular hyperplasia) and MLL; (2) in detection rate of arterial blood flow between HCC with or without LC and CavHA or MLL. The other differences were not statistically significant. Conclusions: According to our findings D.-US can be used for the differentiation of some liver tumours when using the criteria: (a) vessel presence around or in periphery of tumour, and (b) arterial flow pattern in tumour vessels.