The Accuracy and Limitations of Ultrasound in the Assessment of Venous Extension in Renal Carcinoma

Abstract

Ultrasound was used to assess venous extension in 28 patients with renal carcinoma, with particular reference to involvement of the inferior vena cava. The findings were correlated with surgical findings in all except two patients who had gross caval involvement and metastatic disease and in whom surgery was considered inappropriate. In 10 of the 28 patients (36%), a diagnostic ultrasound examination of the cava from the renal veins to the diaphragm was obtained. In four of these, ultrasound showed tumour involvement of the vena cava. In 12 cases (43%) only the intrahepatic part of the cava was seen, but the examination nonetheless excluded tumour involvement of the upper cava. Visualisation of the vena cava was impossible in six cases (21%), usually because of bowel gas or obesity; CT scanning provided valuable additional information in two of these cases. Inferior vena cavography confirmed the findings of the less invasive imaging procedures in 10 patients and was falsely positive once. Cavography is now seldom necessary in the assessment of renal carcinoma.

Fatty liver disease in severe obese patients: Diagnostic value of abdominal ultrasound

“…The second hypothesis is related to the adipose tissue thickness that may cause technical difficulties for the performance of this exam. The thick layers of subcutaneous fat in obese people may mislead the examiner's judgment of liver echogenicity, as cited in visualizing of the abdominal aorta [12] and renal carcinoma [13] . The image quality rate also has been discussed and different results have as been found.…”

A Prospective Study of the Value of Conventional CT, Dynamic CT, Ultrasonography and Arteriography for Staging Renal Carcinoma

“…We found that the visualisation of the renal veins and vena cava was inadequate in 54% and 2 1 % of patients respectively. The corresponding figures from Webb et al (1987) are 75% and 64% and from Schwerk etal. 1985) 34.2% and 4.2%.…”

Diagnostic and Surgical Aspects of Renal Carcinoma with Involvement of the Inferior Vena Cava

“…Vena caval extension should be excluded in all patients with renal carcinoma, since less than half have clinical signs of vena caval obstruction. Ultrasound is an accurate diagnostic technique in these circumstances (Webb et al, 1987) and is the investigation of choice because it is painless, readily available and non-invasive. In this study of 13 patients it yielded only 1 false negative result and even this was recognised as equivocal.…”