Contrast-enhanced ultrasonography for evaluation of cystic renal mass: in comparison to contrast-enhanced CT and conventional ultrasound

Abstract

CEUS was superior to US and CECT in visualizing the number of septa septa and wall thickness, and the presence of solid component of cystic renal lesions. CEUS may play a similar role to CECT in the diagnosis of renal cystic lesions, and better than US.

Contrast enhanced ultrasound of renal masses. A reappraisal of EFSUMB recommendations and possible emerging applications.

“…haemorrhage, inflammation, or ischemia) [3]. The most important elements that guide the diagnosis towards the malignity are represented by enhanced thick intracystic septa and enhanced mural nodules after microbubble injection [4,5]. Due to the partial volume effect these important clues may be masked by CT, which can lead to a misdiagnosis.…”

“…Due to the partial volume effect these important clues may be masked by CT, which can lead to a misdiagnosis. According to several reports, CEUS can improve the diagnostic accuracy of both complex cystic lesions detected by US and indeterminate cystic lesions identified on CT or MRI (fig 1) [4][5][6]. Furthermore several authors showed that CEUS, in non-conclusive renal nodules detected on CT, could differentiate benign complex cysts from other lesions that would require further investigation [7,8].…”

Romanian National Guidelines on Contrast Enhanced Ultrasound in clinical practice

“…Benign lesions typically show no enhancement; this reliably confirms benignity with a 100% PPV [112]. CEUS can identify more septa, characterize them as thicker and pick up solid components within cystic lesions at least as accurately as CT [106,107,109,112]. CEUS can demonstrate slow and low flow within lesions and allows their characterization as solid [113].…”

“…The Bosniak classification system modified for CEUS evaluates the cystic lesions in terms of quantity, thickness and enhancement of walls and septa [111]. Benign lesions typically show no enhancement; this reliably confirms benignity with a 100% PPV [112]. CEUS can identify more septa, characterize them as thicker and pick up solid components within cystic lesions at least as accurately as CT [106,107,109,112].…”

Quantitative assessment of solid renal masses by contrast-enhanced ultrasound with time–intensity curves: how we do it

“…UCAs have an excellent safety profile, with few contraindications [19][20][21][22]. Aside from patients with hypersensitivity to the specific contrast agent, CEUS is also not recommended for patients with right-to-left, bi-directional, or transient right-to-left cardiovascular shunts [16].…”