title: Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors.
abstract: 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.
authors.affiliation: Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 640-0012, Japan. tamahide@wakayama-med.ac.jp
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tamai
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Takiguchi
authors.forename: Masashi
authors.initials: M
authors.lastname: Oka
authors.forename: Naoki
authors.initials: N
authors.lastname: Shingaki
authors.forename: Shotaro
authors.initials: S
authors.lastname: Enomoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Shiraki
authors.forename: Machi
authors.initials: M
authors.lastname: Furuta
authors.forename: Izumi
authors.initials: I
authors.lastname: Inoue
authors.forename: Mikitaka
authors.initials: M
authors.lastname: Iguchi
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Yanaoka
authors.forename: Kenji
authors.initials: K
authors.lastname: Arii
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Hiroya
authors.initials: H
authors.lastname: Nakata
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shinka
authors.forename: Tokio
authors.initials: T
authors.lastname: Sanke
authors.forename: Masao
authors.initials: M
authors.lastname: Ichinose
mesh_terms: D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007680:Kidney Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media