| Objective:This study analyzed whether the hepatic differential distribution of colorectal liver metastases(CRCLM)followed the "portal vein streamline effect".The relationship between CRCLM diameter,primary histopathological grade and the artery enhancement fraction(AEF)of CRCLM,and whether AEF can predict initial response to chemotherapy.Methods:Retrospective analysis was conducted to collect patients with colorectal cancer(CRC)complicated with distant metastasis from January 2018 to August 2020 in the Affiliated Hospital of North Sichuan Medical College.The name,age,sex,location of primary lesion,pathological classification,histological grade,parenchymal organs with distant metastasis,mode of IMV merging into portal vein,dominant distribution of LM,CT value of normal liver parenchyma at each stage,treatmentmethod of LM and location of each LM,diameter beforeand aftertreatment,and CT value at eachstage wererecorded respectively.All data were analyzed by SPSS 25.0 statistical software.Results:1.The location of primary tumor in CRC was correlated with liver and lung metastasis(P=0.006).There was no significant difference in liver and lung metastasis rate between left and right colon cancer(P=0.554).The lower rectal cancer was more prone to lung metastasis(P=0.000).2.LM of left and right colon cancer were mainly located in the right lobe of the liver(P=0.000),while LM of lower rectal cancer were randomly distributed in the liver(P=0.61 7).3.There were no significant difference in the distribution of LM in the left colon cancer with type Ⅰ and type Ⅱ(P=0.763,P=0.196),while the typeⅢ of LM in the left coloncancer was mainly located in the right lobe(P=0.000).4.Excluding the non-enhancement group,the enhancement types of CRCLM with different sizes were statistically significant(P=0.000).The CRCLM with diameter ≤3 cm was mainly in the fast in and slowout type,while the CRCLM with diameter>3cm was mainly in the fast in and fast out type.5.There was no statistically significant difference in portal phase enhancement of CRCLM with different diameters(P=0.433),but the arterial phase enhancement and AEF of the group with diameter>3 cm were higher than those of the group with diameter ≤3cm(P=0.017,P=0.000).6.There were no statistically significant differences in portal vein enhancement and AEF value of CRCLM with different degrees of differentiation(P=0.547,P=0.062).The enhancement of arterial phase showed a decreasing trend in the low,medium and high differentiation groups,and the difference was statistically significant(P=0.006).7.The portal vein phase enhancement in the CRCLM chemotherapy response group was higher than that in the non-response group,and the AEF value was lower than that in the non-response group,thedifference was statistically significant(P=0.013,P=0.044),but there was no significant difference in arterial phase enhancement between the two groups(P=0.724).Conclusion:1.There is no significant difference in liver and lung metastasis rates of colon cancer;Middle and upper rectal cancer is more likely to have liver metastasis,lower rectal cancer is more likely to have lung metastasis.2.The intrahepatic distribution of CRCLM conforms to the "portal vein streamline effect",and the lower rectal cancer liver metastases is randomly distributed.3.The blood supply composition ratio of CRCLM is related to its diameter and primary histopathological grade,and AEF can predict the initial response of patients to chemotherapy. |
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