Evaluation of Contrast Enhanced Ultrasound for Investigation of Complex Cystic Renal Masses

Abstract

Objective: Cystic renal masses are conventionally assessed by contrast CT and/or simple ultrasound scan. Contrast Enhanced Ultrasound (CEUS) is a relatively new investigation which may act as a novel tool for investigation of these masses and the aim of this study was to evaluate this potential. Patients and methods: 19 patients underwent CEUS in our Trust for investigation of complex cystic renal masses. The results were compared with other investigation modalities i.e. CT and simple ultrasound scans. Results: In nine patients, CEUS suggested a benign lesion. In six of these patients, contrast CT and/or simple ultrasound scan were inconclusive. Malignant cystic renal mass was diagnosed in nine patients by CEUS. In five of these patients, contrast CT and/or simple ultrasound scan were indeterminate. Three of the five patients had nephrectomy which confirmed malignancy in two and benign cystic nephroma in the third case. In one patient both simple ultrasound and CEUS were inconclusive whereas a contrast CT scan showed benign lesion. Conclusion: Within limitations of our study, CEUS provided information additional to conventional imaging in eleven patients. It appears to be a useful investigation in conjunction with conventional imaging for investigation of complex cystic renal masses but requires further evaluation.

Bosniak classification system: a prospective comparison of CT, contrast-enhanced US, and MR for categorizing complex renal cystic masses

“…The Bosniak classification was initially developed solely on the basis of CT findings (1–4). Subsequently, a few studies have suggested that MRI (7,8) and CEUS (9–16) may be equally useful for characterization of complex renal cystic masses. These studies are predominantly based on retrospective series.…”

Can contrast enhanced ultrasound differentiate benign cystic nephroma from malignant multicystic renal lesions? A case report

“…Shahzad et al studied several renal lesions of which two were eventually diagnosed as cystic nephroma on histology 3 . They found both had ‘malignant enhancement’ on contrast ultrasound but did not describe quantitatively and it is uncertain if time intensity curves are similar to our case.…”

Bosniak classification of cystic renal masses: utility of contrastenhanced ultrasound using version 2019

“…BC new applies to contrast-enhanced CT and MRI. Although the role of ultrasound is not fully established, CEUS can be potentially useful in the evaluation of complex cystic renal lesions [16,17]. Moreover, CEUS is particularly attractive due to its lower cost, lack of ionizing radiation and non-nephrotoxic microbubble contrast agents.…”