[A contrast with good intentions].
A seventy-five-year-old woman with moderate chronic renal failure was admitted to evaluate a complex renal cyst in the frame of acquired cystic kidney disease. Computed tomography (CT) was performed without contrast media due to the risk of radiocontrast-induced nephrotoxicity. Sonographic investigation at our ultrasound unit revealed a hypoechoic lesion measuring 20x20 mm in size by conventional B-mode sonography, confirmed by NTHI. The Hypoechoic lesion was consistent with complex renal cyst or renal tumour. This finding triggered investigation with CEUS.A sulphur hexafluoride-filled microbubble contrast medium was injected intravenously. The focal lesion CES pattern was characterized by intralesional enhancement in the arterial phase. Further diagnostic imaging including CT with contrast media confirmed a lesion consistent with renal tumour. The patient underwent right-sided nephrectomy; histopathological work-up revealed a renal cell carcinoma. Contrast-enhanced sonography could be clinically useful for the differential diagnosis of kidney lesions in patients with chronic renal failure.
Prencipe
M A
MA
Divisione di Nefrologia e Dialisi, Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo (FG). mikprenc@libero.it
Biancofiore
F
F
Di Giorgio
G
G
Gesuete
A
A
Vergura
M
M
Stallone
C
C
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D052177:Kidney Diseases, Cystic / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D009392:Nephrectomy; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D014463:Ultrasonography / Q000379:methods
D003287:Contrast Media; D013459:Sulfur Hexafluoride