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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Contrast-enhanced Ultrasound for Diagnosis of Renal Cystic Mass

Author(s): Qingqing Xia, Xinchun Yuan*, Meifeng Huang, Xiling Zhou and Zhiyu Zhou

Volume 18, Issue 3, 2022

Published on: 03 January, 2022

Article ID: e190721194902 Pages: 7

DOI: 10.2174/1573405617666210719141831

Price: $65

Abstract

Background: Cystic Renal Cell Carcinoma (CRCC) is often difficult to differentiate from complex cysts with sonographic manifestations of renal carcinoma. Contrast-Enhanced Ultrasound (CEUS) is a new technology, and its clinical utility in the diagnosis of renal cystic mass has not been established.

Objective: The objective of this study is to analyze the characteristics of CEUS of renal cystic masses and to explore the clinical significance and value of CEUS in the diagnosis of CRCC.

Methods: This study was a retrospective study. A total of 32 cystic masses from January 2018 to December 2019 were selected. The images of conventional Ultrasound (US) and CEUS were confirmed via surgical pathology. Routine US was used to observe the location, shape, size, boundary, cyst wall, internal echo, and blood supply of each cystic mass. CEUS observed contrast enhancement of the cyst wall, cystic septa, and solid nodules of cystic masses.

Results: There were 26 cases of CRCC, 5 cases of renal cysts, and 1 case of renal tuberculosis. The enhancement pattern, degree of enhancement, and pseudocapsular sign by CEUS in benign and malignant masses had statistically significant differences (P<.05). In the diagnosis of CRCC, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 92.3%, 83.3%, 90.6%, 96.0%, and 71.4% for CEUS; 57.6%, 66.7%, 59.3%, 88.2%, and 26.7% for conventional US, respectively. CEUS had a higher sensitivity and accuracy than the conventional US (P<.05), although the diagnostic specificity, positive predictive value and negative predictive value of the two methods were not significantly different (P>.05).

Conclusion: CEUS is more accurate in the diagnosis of renal cystic masses, and it can be used as an effective imaging method.

Keywords: Contrast-enhanced ultrasound, conventional ultrasound, renal cystic masses, renal cell carcinoma, cystic masses, MRI.

Graphical Abstract
[1]
Kashan M, Ghanaat M, Hötker AM, et al. Cystic renal cell carcinoma: A report on outcomes of surgery and active surveillance in patients retrospectively identified on pretreatment imaging. J Urol 2018; 200(2): 275-82.
[http://dx.doi.org/10.1016/j.juro.2018.02.3087] [PMID: 29496470]
[2]
Olson MC, Abel EJ, Mankowski Gettle L. Contrast-enhanced ultrasound in renal imaging and intervention. Curr Urol Rep 2019; 20(11): 73.
[http://dx.doi.org/10.1007/s11934-019-0936-y] [PMID: 31624973]
[3]
Park HS, Lee K, Moon KC. Determination of the cutoff value of the proportion of cystic change for prognostic stratification of clear cell renal cell carcinoma. J Urol 2011; 186(2): 423-9.
[http://dx.doi.org/10.1016/j.juro.2011.03.107] [PMID: 21679991]
[4]
Park JJ, Jeong BC, Kim CK, et al. Postoperative outcome of cystic renal cell carcinoma defined on preoperative imaging: A retrospective study. J Urol 2017; 197(4): 991-7.
[http://dx.doi.org/10.1016/j.juro.2016.10.055] [PMID: 27765694]
[5]
Shan K, Fu ABDLAZZHL, Liu N, et al. Contrast-enhanced ultrasound (ceus) vs contrast-enhanced computed tomography for multilocular cystic renal neoplasm of low malignant potential: A retrospective analysis for diagnostic performance study. Medicine (Baltimore) 2020; 99(46): e23110.
[http://dx.doi.org/10.1097/MD.0000000000023110] [PMID: 33181678]
[6]
Silverman SG, Pedrosa I, Ellis JH, et al. Bosniak classification of cystic renal masses, version 2019: An update proposal and needs assessment. Radiology 2019; 292(2): 475-88.
[http://dx.doi.org/10.1148/radiol.2019182646] [PMID: 31210616]
[7]
Hélénon O, Crosnier A, Verkarre V, Merran S, Méjean A, Correas JM. Simple and complex renal cysts in adults: Classification system for renal cystic masses. Diagn Interv Imaging 2018; 99(4): 189-218.
[http://dx.doi.org/10.1016/j.diii.2017.10.005] [PMID: 29482969]
[8]
Lee YJ, Kim SH, Kang BJ, Kim YJ. Contrast-enhanced ultrasound for early prediction of response of breast cancer to neoadjuvant chemapy. Stuttgart, Germany.: Ultraschall in der Medizin. 2019.
[9]
Han BH, Park SB. Usefulness of contrast-enhanced ultrasound in the evaluation of chronic kidney disease. Curr Med Imag 2021; 17(8): 1003-9.
[10]
Bhatt JR, Jewett MA, Richard PO, et al. Multilocular cystic renal cell carcinoma: Pathological T staging makes no difference to favorable outcomes and should be reclassified. J Urol 2016; 196(5): 1350-5.
[http://dx.doi.org/10.1016/j.juro.2016.05.118] [PMID: 27341751]
[11]
Silverman SG, Israel GM, Trinh QD. Incompletely characterized incidental renal masses: Merging data support conservative management. Radiology 2015; 275(1): 28-42.
[http://dx.doi.org/10.1148/radiol.14141144] [PMID: 25799334]
[12]
Correas JM, Claudon M, Tranquart F, Hélénon AO. The kidney: Imaging with microbubble contrast agents. Ultrasound Q 2006; 22(1): 53-66.
[PMID: 16641794]
[13]
Qiu X, Zhao Q, Ye Z, Meng L, Yan C, Jiang TA. How does contrast-enhanced ultrasonography influence bosniak classification for complex cystic renal mass compared with conventional ultrasonography? Medicine (Baltimore) 2020; 99(7): e19190.
[http://dx.doi.org/10.1097/MD.0000000000019190] [PMID: 32049855]
[14]
Harisinghani MG, Maher MM, Gervais DA, et al. Incidence of malignancy in complex cystic renal masses (Bosniak category III): Should imaging-guided biopsy precede surgery? AJR Am J Roentgenol 2003; 180(3): 755-8.
[http://dx.doi.org/10.2214/ajr.180.3.1800755] [PMID: 12591691]
[15]
Goncin U, Ton N, Reddy A, El Kaffas A, Brinkmann M, Machtaler S. Contrast-enhanced ultrasound imaging for assessing organ perfusion in rainbow trout (Oncorhynchus mykiss). Sci Total Environ 2021; 750: 141231.
[http://dx.doi.org/10.1016/j.scitotenv.2020.141231] [PMID: 33182180]
[16]
Lan D, Qu HC, Li N, Zhu XW, Liu YL, Liu CL. The value of contrast-enhanced ultrasonography and contrast-enhanced CT in the diagnosis of malignant renal cystic lesions: A meta-analysis. PLoS One 2016; 11(5): e0155857.
[http://dx.doi.org/10.1371/journal.pone.0155857] [PMID: 27203086]
[17]
Zhou L, Tang L, Yang T, Chen W. Comparison of contrast-enhanced ultrasound with mri in the diagnosis of complex cystic renal masses: A meta-analysis. Acta Radiologica 2018; 59(10): 1254-63.
[http://dx.doi.org/10.1177/0284185118755575]
[18]
Bosniak MA. The Bosniak renal cyst classification: 25 years later. Radiology 2012; 262(3): 781-5.
[http://dx.doi.org/10.1148/radiol.11111595] [PMID: 22357882]
[19]
Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG. The natural history of observed enhancing renal masses: Meta-analysis and review of the world literature. J Urol 2006; 175(2): 425-31.
[http://dx.doi.org/10.1016/S0022-5347(05)00148-5] [PMID: 16406965]
[20]
Moch H. Cystic renal tumors: New entities and novel concepts. Adv Anat Pathol 2010; 17(3): 209-14.
[http://dx.doi.org/10.1097/PAP.0b013e3181d98c9d] [PMID: 20418675]
[21]
Israel GM, Hindman N, Bosniak MA. Evaluation of cystic renal masses: Comparison of CT and MR imaging by using the bosniak classification system. Radiology 2004; 231(2): 365-71.
[http://dx.doi.org/10.1148/radiol.2312031025] [PMID: 15128983]
[22]
Ascenti G, Mazziotti S, Zimbaro G, et al. Complex cystic renal masses: Characterization with contrast-enhanced US. Radiology 2007; 243(1): 158-65.
[http://dx.doi.org/10.1148/radiol.2431051924] [PMID: 17392251]
[23]
Kim S, Jain M, Harris AB, et al. T1 hyperintense renal lesions: Characterization with diffusion-weighted MR imaging versus contrast-enhanced MR imaging. Radiology 2009; 251(3): 796-807.
[http://dx.doi.org/10.1148/radiol.2513080724] [PMID: 19380690]
[24]
Hindman NM, Bosniak MA, Rosenkrantz AB, Lee-Felker S, Melamed J. Multilocular cystic renal cell carcinoma: Comparison of imaging and pathologic findings. AJR Am J Roentgenol 2012; 198(1): W20-6.
[http://dx.doi.org/10.2214/AJR.11.6762] [PMID: 22194510]
[25]
Koga S, Nishikido M, Hayashi T, Matsuya F, Saito Y, Kanetake H. Outcome of surgery in cystic renal cell carcinoma. Urology 2000; 56(1): 67-70.
[http://dx.doi.org/10.1016/S0090-4295(00)00540-9] [PMID: 10869626]
[26]
Winters BR, Gore JL, Holt SK, Harper JD, Lin DW, Wright JL. Cystic renal cell carcinoma carries an excellent prognosis regardless of tumor size. Urol Oncol 2015; 33(12): 505.e9-505.e13.
[http://dx.doi.org/10.1016/j.urolonc.2015.07.017] [PMID: 26319351]

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