Renal perfusion abnormality. Coded harmonic angio US with contrast agent.
OBJECTIVE
Coded harmonic angio (CHA) US is a recently developed technique that can depict the effects of contrast agents. The purpose of this study was to determine the role of this technique in depicting the enhancement patterns of various renal perfusion abnormalities compared with dynamic CT.


METHODS
During a 6-month period, various renal lesions including renal cell carcinoma (n=12), transitional cell carcinoma (n=5), acute pyelonephritis (n=5), and renal trauma (n=2) were evaluated with CHA US using a microbubble contrast agent. US images were obtained before contrast administration and with a bolus injection of 4 g of microbubble contrast agent (300 mg/ml) every 10 s for 1 min and every minute for 5 min. The contrast enhancement patterns of various renal masses were compared with dynamic CT.


RESULTS
Of 12 renal cell carcinomas, 9 (75%) showed heterogeneous enhancement and the remaining 3 (25%) showed homogeneous enhancement. Enhancement of more than adjacent renal parenchyma was seen 16-252 s after injection. The duration of enhancement was 13-208 s (mean, 80 s). All transitional cell carcinomas showed peripheral enhancement. Enhancement was seen 22-270 s after injection. The duration of enhancement was 191-238 s (mean, 291 s). Five patients with acute pyelonephritis and 2 with renal trauma showed focal perfusion defects not shown on the pre-contrast examinations.


CONCLUSIONS
CHA US with microbubble contrast agent is an effective US technique for the evaluation of both tumor vascularity and renal perfusion abnormality.
Kim
J H
JH
Department of Radiology, Soonchunhyang University Hospital, Seoul, Korea. junghkim@hosp.sch.ac.kr
Eun
H W
HW
Lee
H K
HK
Park
S J
SJ
Shin
J H
JH
Hwang
J H
JH
Goo
D E
DE
Choi
D L
DL
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D014463:Ultrasonography
D003287:Contrast Media