Ultraschall Med 2007; 28 - V_5_18
DOI: 10.1055/s-2007-988984

Controversies in contrast-enhanced ultrasound (CEUS) diagnostics of renal cystic lesions – first experiences

A Lewicki 1, M Jêdrzejczyk 2, W Jakubowski 2, W Pypno 3, P Marczyñski 1, A Lewicka 4
  • 1Memorial Lord's Transfiguration Hospital, Urology Department, Warsaw, Poland
  • 2Medical University of Warsaw, Department of Diagnostic Imaging, Warsaw, Poland
  • 3Postgraduate Medical Academy, Urology Department, Warsaw, Poland
  • 4Medical University of Warsaw, Department and Clinic of Obstetrics, Gynecological Disease and Gynecological Oncology, Warsaw, Poland

Objectives: Comparison of CEUS concordance with contrast-enhanced computed tomography (CECT) results in diagnostics of renal cystic lesions.

Methods: We examined 23 cystic renal lesions indeterminated in grey scale ultrasound and 14 cysts examined with primarily indicated tumors. The examination was performed with Voluson730Expert, probe C2–5MHz/3D C2–5MHz. The kidneys were examined three times: grey scale with Doppler, after repeated bolus injection of 1,2ml SonoVue Coded Pulse Inversion option (MI:0,16–0,22) and Coded Harmonic Angio option (MI: 0,9–1,3). Vascularization (blood flow in walls, septa and solid components) and enhancement character were evaluated. Examined lesions were classified according to the Bosniak system. All results were compared to CECT.

Results: In CEUS lesions were classified as follows: category I –16, II –4, IIF –7, III –6, IV –4. In 23 cases we had histopathological outcomes: renal cell carcinoma –3, lymphoma –1, leiomyoma –1, multilocular cystic nephroma –1, benign cysts –17.

Concordance between CEUS and CECT was: category I –100%(16/16), II –75%(3/4), IIF –71,4%(5/7), III –83%(5/6), IV also 100%(4/4).

Differences will be discussed during the presentation. Both imaging methods gave false results in comparison with histopathological examination.

Conclusions: Qualification of renal cystic lesions by CEUS according to the Bosniak system is similar to CECT. However it seems that CEUS has higher sensitivity in detection of flow in septa than CECT which may cause diagnostic controversies. Further studies are reqired to confirm preliminary data and establish their implication.

The work is supported by scientific grant from the Ministry of Science and Higher Education No 2PO5B05330