Abstract
Background: Within the term “pseudotumors” are grouped some renal anatomic variations that may simulate a focal renal lesion at ultrasonography. Our purpose was to assess the accuracy of contrast-enhanced ultrasonography (CEUS) using a second-generation contrast agent in the diagnosis of renal pseudotumors. Methods: We retrospectively retrieved CEUS examinations performed in 24 patients for characterization of suspected renal pseudotumor, in which conventional and power Doppler US study had been unable to confidently exclude a neoplasm. The considered criterion to define the diagnosis of renal pseudotumor was the demonstration of the same perfusion and reperfusion after microbubble breakage in both pseudotumor and surrounding parenchyma during early and late corticomedullary phase. In all patients, multiphase CT or dynamic MRI was available, representing a standard of reference for this study. In cases of CT or MRI diagnosis of renal lesion, final diagnoses were obtained with percutaneous renal biopsy or with surgery. Results: Contrast-enhanced ultrasonography diagnosis was concordant with MR or CT images in all cases. Conclusion: In our experience CEUS shows complete concordance with CT and MRI in the characterization of all 24 pseudotumors considered dubious at conventional and power Doppler US. The appropriate use of CEUS can reduce the need for contrast-enhanced CT or dynamic MRI in this item.
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References
Marchal G, Verbeken E, Ogen R et al. Ultrasound of the normal kidney: a sonographic, anatomic and histologic correlation. Ultrasound Med Biol 1986; 12: 999–1009.
Helenon O, Correas JM, Balleyguier C et al. Ultrasound of renal tumors. Eur Radiol 2001; 11:1890–1901.
Paspulati RM, Bhatt S. Sonography in benign and malignant renal masses. Ultrasound Clin 2006; 1: 25–41.
Simpson EL, Mintz MC, Pollack HM et al. Computed tomography in the diagnosis of renal pseudotumors. J Comput Assist Tomogr 1986; 10: 341–348.
Tello R, Davison BD, O’Malley M et al.MR imaging of renal masses interpreted on CT to be suspicious. AJR 2000; 174: 1017–1022.
Ascenti G, Zimbaro G, Mazziotti S et al. Contrast-enhanced power Doppler US in the diagnosis of renal pseudotumors. Eur Radiol 2001; 11: 2496–2499.
Robbin ML, Lockhart ME, Barr RG. Renal imaging with ultrasound contrast: current status. Radiol Clin North Am 2003;41: 963–978.
Nilsson A: Contrast-enhanced ultrasound of the kidneys. Eur Radiol 2004; 8(Suppl): 104–109.
Tranquart F, Correas JM, Martegani A, Greppi B, Bokor D: Feasability of real time contrast-enhanced ultrasound in renal disease. J Radiol 2004; 85: 31–36.
Setola SV, Catalano O, Sandomenico F, Siani A. Contrast-enhanced sonography of the kidney. Abdom Imaging 2007; 31:21–28.
Landis JR, Koch GG. The measurement of observer agreement for categorial data. Biometrics 1977; 33: 159–174.
Fleiss JL (1981) Statistical Methods for Rates and Proportions, 2nd edn. New York: John Wiley & Sons, pp 217–218
Yeh HC, Halton KP, Shapiro RS et al. Junctional parenchyma: revised definition of hypertrophic column of Bertin. Radiology 1992; 185: 725–732.
Patriquin H, Lefaivre JF, Lafortune M et al. Fetal lobation. An anatomo-ultrasonographic correlation. J Ultrasound Med 1990; 9: 191–197.
Lafortune M, Constantin A, Breton A, Vallee C. Sonography of the hypertrophied column of Bertin. AJR 1986; 146: 53–56.
Hardwick D, Hendry GMA. Ultrasonic appearances of the septa of Bertin in children. Clin radiol 1984; 35: 107–112.
Jinzaki M, Ohkuma T, Tanimoto A et al. Small solid renal lesion: usefulness of power Doppler US. Radiology 1998; 209: 543–550.
Robbin ML. Sonographic contrast agents in the kidney. In: Nanda NC, Schlief R, Goldberg BB (eds). Advances in echo imaging using contrast enhancement. Kluwer, Dordrecht, 1997: 525–541.
Bauer A, Hauff P, Lazenby J, et al. (1999) Wideband harmonic imaging: a novel contrast ultrasound imaging technique. Eur Radiol 9(Suppl 3):364–367.
Ascenti G, Gaeta M, Mazziotti S et al. Contrast-Enhanced second-harmonic sonography in the detection of pseudocapsule in renal cell carcinoma. AJR 2004;182:1525–1530.
Barr RG, Robbin ML, Peterson C: Definity-enhanced ultrasound imaging of the kidney in patients with indeterminate masses: value of contrast harmonic imaging with bolus and infusion administration. Radiology 2001; 221 (suppl.): 316.
Quaia E, Siracusano S, Bertolotto M et al.: Characterization of renal tumours with pulse inversion harmonic imaging by intermittent high mechanical index technique: initial results. Eur Radiol 2003; 13: 1402–1412.
Correas JM, Claudon M, Tranquart F, Helenon O. The Kidney: Imaging with Microbubble Contrast Agents. Ultrasound Q 2006; 22:53–66.
Claudon M, Cosgrove D, Albrecht T, Bolondi L, Bosio M, Calliada F, Correas JM, Darge K, Dietrich C, D’onofrio M, Evans DH, Filice C, Greiner L, Jager K, de Long N, Leen E, Lencioni R, Lindsell D, Martegani A, Meairs S, Nolsoe C, Piscaglia F, Ricci P, seidel G, Skjoldbye B, Solbiati L, Thorelius L, Tranquart F, Weskott HP, Whittingham T. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)—update 2008. Ultraschall Med 2008; 29: 28–44
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Mazziotti, S., Zimbaro, F., Pandolfo, A. et al. Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors. Abdom Imaging 35, 241–245 (2010). https://doi.org/10.1007/s00261-008-9499-y
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DOI: https://doi.org/10.1007/s00261-008-9499-y