Background & objective: The blood supply of liver metastatic tumors affects the selection of administration approach and target vessels of interventional therapy. This study was to investigate the blood supply of liver metastatic tumors with both CT arterial portography (CTAP) via the superior mesenterica arterial (SMA) and multi-slice spiral CT perfusion imaging.
Methods: Twenty patients with liver metastatic tumors received CTAP via SMA and multi-slice spiral CT perfusion imaging. The CT values of 33 metastatic lesions and 20 specimens of normal liver tissue from the patients were measured through the time-density curves (TDC) of region of interest (ROI). The blood flow (BF), blood volume (BV), mean transit time (MTT), capillary vessel permeability surface (PS) of the portal vein were calculated with single-blood perfusion model.
Results: The diameters of the 33 metastatic lesions were 0.8-3.5 cm. The increment of CT values after enhancement was no more than 10 Hu in all lesions. At portal venous phase of SMA-digital subtraction angiography (DSA), no tumor vessel was found in the lesions. The BF, BV, MTT, and PS of the portal vein were (17.15+/-11.38) ml x min-(1) x 100 ml-(1), (1.62+/-0.97) ml x 100 g-(1), (9.47+/-2.78) s, and (3.97+/-3.44) ml x min-(1) x 100 ml-(1), respectively, in metastatic lesions, and were (133.43+/-67.17) ml x min-(1) x 100 ml-(1), (16.56+/-11.15) ml x 100 g-(1), (9.52+/-2.84) s, (35.16+/-14.03) ml x min-(1) x 100 ml-(1), respectively, in normal liver tissues. The differences in BF, BV and PS between the 2 groups were significant (P<0.001). However, the difference in MTT was not significant (P=0.96).
Conclusions: CTAP via SMA can be used to measure accurately portal venous flow. The portal vein is not involved in the blood supply of liver metastatic tumors.