Abstract
Purpose Renal lesions are frequent random findings on CT, MRI, and
conventional ultrasound. Since they are usually found accidentally, the
respective examinations have not been performed optimally to provide a
conclusive diagnosis, making additional multiphase contrast-enhanced
examinations necessary. The aim of the study is to correlate CEUS findings with
the final diagnosis and to determine whether it is a suitable method for the
conclusive characterization of undetermined renal lesions.
Materials and Methods All CEUS examinations of focal renal lesions
performed at our institute between 2007 and 2014 were retrospectively examined.
437 patients with a total of 491 lesions and 543 examinations were included. 54
patients had bilateral lesions. One patient had three lesions in one kidney.
Histology was available in 49 cases and follow-ups in 124 cases. The
sensitivity, specificity, positive and negative predictive value as well as
positive and negative likelihood ratios were calculated.
Results There were 54 malignant and 437 benign lesions. The sensitivity
and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic
lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the
histologically confirmed lesions. Bosniak classification was consistent in 289
of 301 lesions (96%). Only 12 lesions (3.9%) were falsely
assessed as malignant.
Conclusion CEUS is an appropriate method for the clarification of
undetermined renal lesions. The characterization of cystic lesions according to
Bosniak is adequately possible, especially for potentially malignant lesions
(types III and IV).
Characterization of Pancreatic Tumors with Quantitative Perfusion Analysis in Contrast-Enhanced Harmonic Endoscopic Ultrasonography