Usefulness of color Doppler flow imaging in differential diagnosis of multilocular cystic lesions of the kidney.

Abstract

Color Doppler flow imaging was carried out in 10 multilocular cystic lesions of the kidney. These consisted of three renal cell carcinomas, three hemorrhagic renal cysts, one benign multilocular cystic nephroma, two infected renal cysts, and one benign multilocular renal cyst secondary to von Hippel-Lindau disease. In the patients with renal cell carcinoma, color signals were obtained at the septum and in the solid component within the lesions. A pulsatile wave with a large maximum flow velocity and a high PI value was obtained in two of them. In one of the patients with hemorrhagic renal cysts, color signals were obtained at the region of the septum. In the other benign lesions, however, color signals were obtained only at the peripheral margin, and the flow waveform in these cases was identical to the waveforms found in the interlobar arteries. This study suggested that color display in the lesion well reflects its vascularity in patients with multilocular cystic renal diseases and that measurement of the systolic maximum flow velocity by fast Fourier transform analysis is useful for the differential diagnosis of malignant versus benign lesions.

Renal Cystic Nephroma, a Diagnostic Challenge and Dilemma since 19th Century, A Literature Review

“…The tumor is composed with of anechoic, multi-cystic or multilocular lesions delineated by hyperechoic septa without solid mass. Doppler is suggested as useful in the differentiation of benign and malignant multilocular cystic lesions [15].…”

Adult multilocular cystic nephroma: Report of six cases with clinical, radio-pathologic correlation and review of literature

“…Both needle-guided aspiration and color Doppler ultrasound have been proposed to help differentiate between benign and malignant multilocular cystic lesions. [19]…”

“…MCN is considered to be of benign nature in adults; tumor recurrences have been observed and whether these recurrences are related to the missed foci of malignant area or sarcomatous degeneration is not clear. [19] These recurrences are more often seen after partial nephrectomy. So far, only four cases of local recurrences have been reported, all following partial nephrectomy.…”

Imaging of renal masses and staging of renal tumours

“…The finding of more complex features on ultrasound, such as nodularity, calcification, multiple septations and septal or wall thickening, warrants a CT (or MRI) scan for a more accurate assessment of the lesion (Figure 1). Routine use of colour or power Doppler for complex cysts can help to categorize complexity, 21 such that any lesion showing flow within internal septa must be at least category III. The absence of flow, however, cannot be taken as evidence of a lower category.…”