Ultraschall Med 2005; 26 - P053
DOI: 10.1055/s-2005-917553

EVALUATION OF FOCAL RENAL LESIONS WITH CONTRAST ENHANCED GREY-SCALE HARMONIC ULTRASOUND

F Frauscher 1, L Pallwein 1, J Gradl 1, M Schurich 1, A Pelzer 1, A Klauser 1
  • 1Radiology II, Medical University Innsbruck, Innsbruck, Austria

Purpose: To assess the value of contrast enhanced grey-scale harmonic ultrasonography (CEUS) in differential diagnosis and delineation of focal renal lesions

Methods and Materials: 23 focal renal lesions were examined prospectively with CEUS using SonoVue® (Bracco, Italy) performing bolus injection (2.5ml) and an Acuson Sequoia, Mountain View, CA (4Hz, low MI=0.3; pulse- inversion imaging). Diagnosis was based on CT and/or Histology (renal cell carcinoma (RCC) n=11; transitional cell cancer (TCC) n=2, angiosarcoma n=1; cystic lesion Bosniak II-IV n=5; hypertrophic columna n=1; regenerating nodule n=3)

Results: RCCs showed a high contrast agent uptake during arterial phase and a contrast agent “wash out“ during venous phase. TCCs demonstrated a low, increasing enhancement during arterial and venous phase. Benign lesions (hypertrophic columna and regenerating nodule) showed contrast enhancement equal to the renal cortex and no wash out. Bosniak II cystic lesions had no contrast agent uptake. These enhancement patterns were associated with the either benign or malign nature of the lesion (p=0.02; Chi Quadrat test).

Conclusions: CEUS with SonoVue® improves lesion delineation and lesion detection rate of small renal masses. The enhancement pattern of a lesion yielded important information for the differential diagnosis between benign and malign focal renal lesions.