Diagnostic Efficacy of Contrast-Enhanced Ultrasound for Small Renal Masses

Abstract

PurposeUltrasound (US) is highly sensitive in the detection of renal masses. However, it may not be able to differentiate benign and malignant lesions in smaller masses. The purpose of this study was to determine the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) for small renal masses.Materials and MethodsFrom January 2011 to December 2013, a total of 85 patients underwent CEUS for evaluation of renal masses. Of these patients, CEUS findings were retrospectively analyzed for small renal cell carcinoma (RCC) cases (n=38) and angiomyolipoma (AML) cases (n=11). The tumor echogenicity and enhancement patterns and degrees were evaluated. The diagnostic efficacy of CEUS in differentiating the two diseases was compared.ResultsOn CEUS, the findings of diffuse heterogeneous enhancement (observed in 78.9% of RCCs and 27.3% of AMLs, p=0.003), washout from hyperenhancement or iso-enhancement to hypoenhancement in late phase (73.7% of RCCs and 18.2% of AMLs, p=0.001), and perilesional rim-like enhancement (57.9% of RCCs and 9.1% of AMLs, p=0.006) were significantly different between AML and RCC cases. The corresponding sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 86.8% (33/38), 63.6% (7/11), 89.2% (33/37), 58.3% (7/12), and 81.6% (40/49), respectively.ConclusionsOur results suggest that the characteristic CEUS features could have diagnostic value in the evaluation of small renal mass. CEUS showed a higher diagnostic efficacy than conventional US for differentiating RCC and AML.

Clinical utility of contrast‐enhanced ultrasonography in the diagnosis of benign and malignant small renal masses among Asian population

“…The sensitivity and specificity of CEUS were 86.8% and 63.36%, respectively. Their findings were slower than that of the present study . Wei and his colleagues also compared the diagnostic efficiency of CEUS with that of contrast‐enhanced CT in 118 patients with the small renal masses.…”

The independent indicators for differentiating renal cell carcinoma from renal angiomyolipoma by contrast-enhanced ultrasound

“…However, it has limited use when attempting to differentiate between RCC and AML because of its lower accuracy in the characterization of some renal masses [7]. To the extent known, hypoechoic renal masses are mostly considered to be malignant while hyperechoic and iso-echoic renal masses are often referred to as benign.…”

The diagnostic value of contrast-enhanced ultrasound in differentiating small renal carcinoma and angiomyolipoma

“…The current findings were consistent with the results of previous studies. In a prospective study of 49 lesions (38 RCCs and 11 AMLs), Oh et al (15) reported that CEUS had a sensitivity of 86.8%, a specificity of 63.6%, an accuracy of 81.6%, a positive predictive value of 89.2% and a negative predictive value of 58.3%. In a study of 137 lesions (117 RCCs and 20 AMLs), Ignee et al (6) reported that CEUS had a sensitivity of 97%, a specificity of 45%, an accuracy of 90%, a positive predictive value of 91%, and a negative predictive value of 75%.…”