Clinical Application of Ultrasound in the Diagnosis and Treatment of Reninoma

Abstract

To investigate the clinical value of ultrasound in the diagnosis and treatment of reninoma. Methods:We retrospectively analyzed the ultrasound findings of 9 patients with reninoma confirmed by pathology after surgical resection in our hospital between September 2012 and August 2019. All patients underwent conventional preoperative ultrasonography. Three underwent contrast-enhanced ultrasound (CEUS) and 3 with complete endogenetic tumor underwent intraoperative ultrasonography.Results: Of the 9 patients with conventional ultrasound, 7 had renal space-occupying lesions and 2 had missed diagnosis. A hypoechoic or hyperechoic solid mass with regular morphology, clear boundary, capsule, weak echo halo around the mass, incomplete thin strip color blood flow signal around the mass were shown in 7 cases. Color Doppler displayed color flow signal of the incomplete thin strip around the mass and arterial blood supply with an internal thin branch. In 3 patients (including 2 with missing diagnosis by conventional ultrasound) who underwent preoperative contrast-enhanced ultrasound, the reninoma manifested as low enhancement, and the perfusion pattern showed as slow wash-in and slow wash-out compared with normal renal cortex. In 3 patients (including 2 cases of missed diagnosis by conventional ultrasound) with completely endogenic reninoma, intraoperative ultrasound clearly showed the tumor characteristics, and all successfully underwent laparoscopic ultrasound-guided partial nephrectomy. Conclusions:Preoperative conventional ultrasound combined with CEUS, and clinical features, are helpful for the qualitative diagnosis of reninoma. Laparoscopic partial resection is the first-choice treatment for reninoma. Intraoperative ultrasound can provide real-time imaging, accurately evaluate the tumor status, and provide important information for surgeons.

How to identify juxtaglomerular cell tumor by ultrasound: a case series and review of the literature

“…They were complete endophytic, and showed hypoenhancement, slow wash in and slow wash out. One was 1.0 × 1.0 × 0.7 cm, the other was 3.0 × 2.0 × 1.0 cm [25]. The small sample size precluded a firm recommendation of contrast enhanced ultrasound for JGCT diagnosis.…”

“…Taken together, contrast enhanced CT should be considered in all cases of JGCT. Contrast enhanced ultrasound might be helpful [4,25]. Li et al reported two cases of JGCT, invisible by previous conventional ultrasound, found by contrast enhanced ultrasound.…”

“…Eighty-five papers (65 papers in PubMed and 20 papers in Embase) were retrieved. A total of 25 patients in 13 papers met the inclusion criteria including 17 females and 8 males with a median age of 24 years (11-57 years) [4,11,[15][16][17][18][19][20][21][22][23][24][25]. All tumors were solitary, with a median size of 3.3 cm (0.6-6.5 cm).…”