Hemodynamic and sinusoidal function change during multistep hepatocarcinogenesis : evaluation by contrast harmonic imaging

肝癌的发生是一个多步骤的过程，从增生结节到早期HCC，通过早期显性HCC，最终发展为晚期显性富血管HCC。在此过程中，结节内血流动力学也发生变化。我们在这项研究中阐明，在癌发生的初始阶段，血流动力学模式显示动脉血管与低血管和门静脉灌注（I型）。在下一步中，动脉和门静脉血液供应减少（II型）。随后，结节内动脉血供增加到等血供（III型），然后增加到血供过多（IV型）。另一个血流动力学转变发生在从初始模式到结节中结节模式（在门脉灌注的低血管背景中具有区域血管斑点的动脉血管分布（V型））。通过包括原始数据管理技术和累积图像技术（MIP图像）的若干技术的发展，已经开发了纯动脉相位成像。通过这种方法，已经有可能从动脉血流中分离分析结节内门静脉血流，这是一种新的技术。这是不可能的CT或MRI。肝细胞癌、异型增生结节和结节中结节型HCC可以通过使用这种技术（纯动脉期成像）成功地诊断。

Hepatocarcinogenesis is a multistep process, evolving from a hyperplastic nodule to early HCC, through early overt HCC, eventually to advanced overt hypervascular HCC. During this process, changes in intranodular hemodynamics also occur. We clarified in this research that at the initial phase of carcinogenesis, the hemodynamic pattern shows arterial vascularity with hypovascular and portal perfusion (type I). In the next step, both arterial and portal blood supplies decrease (type II). Subsequently, intranodular arterial vascularity increases to isovascularity (type III), and then to hypervascularity (type IV). Another hemodynamic transition occurs from the initial pattern to nodule-in-nodule pattern (arterial vascularity with regional vascular spots in a hypovascular background of portal perfusion (type V).Pure arterial phase imaging has been developed by a development of several technologies including Raw data management technology and accumulation image technology (MIP image). By this method, separate analysis of intranodular, portal flow from arterial flow has been possible, which is a novel technique. This was not possible by CT or MRI. Hepatocellular carcinoma, dysplastic nodule, and nodule-in-nodule type HCC can be successfully diagnosed by using this technique, pure arterial phase imaging.