title: [Value of real-time contrast-enhanced ultrasound in diagnosis of renal solid renal lesions].
abstract: OBJECTIVE
  To investigate the value of real-time contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of renal solid renal lesions (RSLs).
  
  
  METHODS
  We retrospectively analyzed 140 cases of 152 RSLs with a mean diameter 3.1∓1.9 cm. CEUS was performed and the perfusion characteristics were analyzed using contrast pulse sequences (CPS) technique. CEUS findings were compared with biopsy histopathologic findings.
  
  
  RESULTS
  A total of 137 malignant lesions (including 127 renal clear cell carcinomas, 8 renal papillary carcinomas and 2 chromophobe cell carcinomas) and 15 benign lesions (13 angiomyolipomas and 2 renal oncocytomas) were detected. Of the 137 malignant lesions, 98 (71.5%) showed contrast agent fast perfusion and hyper-enhancement or iso-enhancement in cortical phase, 104 (75.9%) showed hypo-enhancement in later corticalmedullary and late phase, and 125 (91.2%) showed rim-like enhancement. Tumors with a diameter ≤2 cm presented with homogeneous enhancement, and those ranging from 2 to 4 cm showed heterogeneous enhancement with a honeycomb feature; tumors greater than 4 cm featured heterogeneous enhancement with large no-enhancement necrotic areas. Of the benign lesions, 13 angiomyolipomas and 2 renal oncocytomas showed slow wash-in and slow wash-out mode. The diagnostic specificity, accuracy and positive predictive value of CEUS for RSLs were 94.9%, 96.1%, and 73.7%, as compared to 72.3%, 71.1%, and 19.1% with conventional US, respectively (P<0.001). The sensitivity and negative predictive value of CEUS were 93.3% and 99.2%, respectively, significantly higher than those of conventional US (60% and 94.3%, P=0.084, and 0.062, respectively).
  
  
  CONCLUSIONS
  Real-time CEUS can provide valuable information for improving the diagnosis and differential diagnosis of RSLs.
authors: Department of Interventional Ultrasound, General Hospital of PLA, Beijing 100853, China.E-mail: lixin301@hotmail.com.
authors: Xin
authors: X
authors: Li
authors: Ping
authors: P
authors: Liang
authors: Xiaoling
authors: X
authors: Yu
authors: Jie
authors: J
authors: Yu
authors: Zhigang
authors: Z
authors: Cheng
authors: Zhiyu
authors: Z
authors: Han
authors: Fangyi
authors: F
authors: Liu
authors: Mengjuan
authors: M
authors: Mu
mesh_terms: D018249:Adenoma, Oxyphilic / Q000000981:diagnostic imaging; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D003287:Contrast Media