Evaluation of intratumoral hemodynamics with color Doppler imaging in patients with colorectal carcinoma: comparison between waveform analysis and histopathologic characteristics.

ABSTRACT

PURPOSE: We studied the relation between intratumoral hemodynamics and histopathologic characteristics in patients with colorectal carcinoma. METHODS: A series of 82 patients with 28 well-differentiated adenocarcinomas, 40 moderately differentiated adenocarcinomas, 10 poorly differentiated adenocarcinomas, and 4 mucinous adenocarcinomas underwent color Doppler examination and surgical treatment. The waveform of blood flow in the thickened wall of the colon was analyzed by determining the maximum velocity (Vmax) and resistance index (RI). These parameters were compared with histopathologic findings of the resected specimens gross form, tumor size, depth of invasion, histologic stage, and histopathologic classification. RESULTS: Both Vmax and RI were higher in the invasive tumors rather than the expansive ones. Vmax and tumor size were not correlated; however, the RI increased proportionately with tumor size in tumors larger than 4 cm in diameter. Both parameters increased with depth of invasion and histologic stage through stage IIIb. Both were markedly higher in mucinous adenocarcinomas than in the other histopathologic types. Furthermore, Vmax in well, moderately, and poorly differentiated adenocarcinomas did not differ significantly, although RI was negatively associated with the degree of differentiation. CONCLUSIONS: We concluded that blood-flow analysis is closely associated with histopathologic findings of colorectal carcinomas and that it provides information useful in the clinical management of these patients.