Radiology, Vol 195, 113-116, Copyright © 1995 by Radiological Society of North America
Detection of colorectal liver metastases: comparison of laparotomy, CT, US, and Doppler perfusion index and evaluation of postoperative follow- up results
E Leen, WJ Angerson, H Wotherspoon, B Moule, TG Cook and CS McArdle
Department of Radiology, Royal Infirmary, Glasgow, Scotland.
PURPOSE: To assess the value of the Doppler perfusion index (DPI = the
ratio of hepatic arterial to total liver blood flow) as measured with
duplex and color Doppler sonography (DCDS) in comparison with computed
tomography (CT), conventional ultrasound (US), and laparotomy for the
detection of liver metastases in patients with colorectal cancer. MATERIALS
AND METHODS: DCDS measurement of the DPI and CT, US, and laparotomy were
performed in 161 consecutive colorectal cancer patients. Patients who
underwent an apparently curative resection were followed up at 3-month
intervals with US and at annual CT. RESULTS: Fifty-six patients had
histologically proved liver metastases at initial examination. Liver
metastases were detected with DPI, CT, US, and laparotomy in 56, 45, 27,
and 36 patients, respectively. After a 1- year follow-up, 23 patients had
developed liver metastases, all of which were predicted on the basis of an
abnormal DPI value. CONCLUSION: Results suggest that DCDS measurement of
the DPI is the most sensitive technique in detection of colorectal liver
metastases. All studies should attempt to define normal liver on the basis
of follow-up results rather than those of laparotomy.
