title: [A contrast with good intentions].
abstract: 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.
authors.affiliation: Divisione di Nefrologia e Dialisi, Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo (FG). mikprenc@libero.it
authors.forename: M A
authors.initials: MA
authors.lastname: Prencipe
authors.forename: F
authors.initials: F
authors.lastname: Biancofiore
authors.forename: G
authors.initials: G
authors.lastname: Di Giorgio
authors.forename: A
authors.initials: A
authors.lastname: Gesuete
authors.forename: M
authors.initials: M
authors.lastname: Vergura
authors.forename: C
authors.initials: C
authors.lastname: Stallone
mesh_terms: 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
chemical_list: D003287:Contrast Media; D013459:Sulfur Hexafluoride