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© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:1635-1640 • 0278-4297

Contrast-Enhanced Ultrasonography in the Diagnosis of Solid Renal Tumors

Hideyuki Tamai, MD, Yoshie Takiguchi, MT, Masashi Oka, MD, Naoki Shingaki, MD, Shotaro Enomoto, MD, Tatsuya Shiraki, MD, Machi Furuta, MD, Izumi Inoue, MD, Mikitaka Iguchi, MD, Kimihiko Yanaoka, MD, Kenji Arii, MD, Yasuhito Shimizu, MD, Hiroya Nakata, MD, Toshiaki Shinka, MD, Tokio Sanke, MD and Masao Ichinose, MD

Second Department of Internal Medicine (H.T., M.O., N.S., Ta.S., I.I., M.I., K.Y., K.A., Y.S., H.N., M.I.) and Department of Urology (Tos.S.), Wakayama Medical University, Wakayama, Japan; and Laboratory Center, Wakayama Medical University Hospital, Wakayama, Japan (Y.T., M.F., Tok.S.).

Address correspondence to Hideyuki Tamai, MD, Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 640-0012, Japan. E-mail: tamahide{at}wakayama-med.ac.jp

Objective. The purpose of this study was to evaluate the usefulness of contrast-enhanced ultrasonography (CEUS) in the diagnosis of solid renal tumors. Methods. Twenty-nine patients with solid tumors detected on gray scale ultrasonography underwent resection for suspected renal malignancy. Findings of arterial phase contrast computed tomography (CT) and CEUS were compared for each diagnosis. Results. Histopathologic examination of resected lesions showed malignancy in 26 patients (clear cell carcinoma, n = 18; papillary renal cell carcinoma, n = 6; collecting duct carcinoma, n = 1; and infiltrative urothelial carcinoma, n = 1) and benign tumors in 3 patients (oncocytoma, n = 2; and angiomyolipoma, n = 1). Contrast CT failed to show tumor blood flow in 5 of 29 patients, whereas CEUS showed this in all patients. Positive predictive values of CEUS and contrast CT in the diagnosis of renal malignancy were 100% and 82.8%, respectively. Among clear cell carcinomas, hypervascularity was observed on contrast CT in 16 of 18 patients and on CEUS in 17 of 18 patients. On the basis of hypervascularity, diagnostic sensitivity values for clear cell carcinoma were 94.4% for CEUS and 88.9% for contrast CT, whereas specificity values were 45.5% for CEUS and 72.7% for contrast CT. Among papillary cell carcinomas, contrast CT showed avascular lesions in 4 of 6 patients. However, CEUS showed blood flow in these lesions, leading to diagnosis of hypovascular renal tumors. Conclusions. Contrast-enhanced ultrasonography was more sensitive for detecting slight tumor blood flow than contrast CT and was useful in preoperatively diagnosing malignant hypovascular renal tumors but was less so for hypervascular renal tumors.

Key Words: clear cell carcinoma • contrast computed tomography • contrast-enhanced ultrasonography • renal tumor

Abbreviations: CEUS, contrast-enhanced ultrasonography • CT, computed tomography • MRI, magnetic resonance imaging




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L. Fan, D. Lianfang, X. Jinfang, S. Yijin, and W. Ying
Diagnostic Efficacy of Contrast-Enhanced Ultrasonography in Solid Renal Parenchymal Lesions With Maximum Diameters of 5 cm
J. Ultrasound Med., June 1, 2008; 27(6): 875 - 885.
[Abstract] [Full Text] [PDF]


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Copyright © 2005 by the American Institute of Ultrasound in Medicine.