Portal hemodynamics in patients with hepatocellular carcinoma.

The protal blood flow was assessed in 46 patients with hepatocellular carcinoma, 81 with cirrhosis, and 110 control subjects using an ultrasonic B-mode pulsed Doppler duplex system. The cross-sectional area of the portal vein was increased, and the velocity of portal blood flow was decreased in hepatocellular carcinoma and cirrhosis, whereas the blood flow volume was not significantly different. A significant decrease in portal blood flow was found in hepatocellular carcinoma only when at least three of the four major branches of the portal vein were occluded. The change in portal hemodynamics before and after transcatheter arterial embolization (TAE) was investigated. Immediately after TAE, neither portal venous pressure nor portal blood flow showed any constant trend. The portal blood flow reached a peak 1 week after TAE and then returned to its former value after 3-4 weeks, while all cases with poor prognoses showed a drop in portal blood flow after TAE.