Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors.
BACKGROUND
Within the term "pseudotumors" are grouped some renal anatomic variations that may simulate a focal renal lesion at ultrasonography. Our purpose was to assess the accuracy of contrast-enhanced ultrasonography (CEUS) using a second-generation contrast agent in the diagnosis of renal pseudotumors.


METHODS
We retrospectively retrieved CEUS examinations performed in 24 patients for characterization of suspected renal pseudotumor, in which conventional and power Doppler US study had been unable to confidently exclude a neoplasm. The considered criterion to define the diagnosis of renal pseudotumor was the demonstration of the same perfusion and reperfusion after microbubble breakage in both pseudotumor and surrounding parenchyma during early and late corticomedullary phase. In all patients, multiphase CT or dynamic MRI was available, representing a standard of reference for this study. In cases of CT or MRI diagnosis of renal lesion, final diagnoses were obtained with percutaneous renal biopsy or with surgery.


RESULTS
Contrast-enhanced ultrasonography diagnosis was concordant with MR or CT images in all cases.


CONCLUSIONS
In our experience CEUS shows complete concordance with CT and MRI in the characterization of all 24 pseudotumors considered dubious at conventional and power Doppler US. The appropriate use of CEUS can reduce the need for contrast-enhanced CT or dynamic MRI in this item.
Mazziotti
Silvio
S
Department of Radiological Sciences, University of Messina, Policlinico G. Martino, Messina, Italy. smazziotti@unime.it
Zimbaro
Fabrizio
F
Pandolfo
Alessia
A
Racchiusa
Sergio
S
Settineri
Nicola
N
Ascenti
Giorgio
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006571:Heterocyclic Compounds; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler / Q000379:methods*
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C093233:iobitridol; D007472:Iohexol; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate