Qualitative and quantitative analysis with contrast-enhanced ultrasonography: diagnosis value in hypoechoic renal angiomyolipoma.
OBJECTIVE
To evaluate the value of enhancement features and quantitative parameters of contrast-enhanced ultrasonography (CEUS) in differentiating solid hypoechoic renal angiomyolipomas (AMLs) from clear cell renal cell carcinomas (ccRCCs).


METHODS
We analyzed the enhancement features and quantitative parameters of CEUS in 174 hypoechoic renal masses (32 AMLs and 142 ccRCCs) included in the study.


RESULTS
Centripetal enhancement pattern was more common in AMLs than in ccRCCs on CEUS (71.9% vs. 23.2%, p < 0.001). At peak enhancement, all AMLs showed homogeneous enhancement (100% in AML, 27.5% in ccRCCs; p < 0.001). Quantitative analysis showed no significant difference between rise time and time to peak. Tumor-to-cortex (TOC) enhancement ratio in AMLs was significantly lower than that in ccRCCs (p < 0.001). The criteria of centripetal enhancement and homogeneous peak enhancement together with TOC ratio < 91.0% used to differentiate hypoechoic AMLs from ccRCCs resulted in a sensitivity and specificity of 68.9% and 95.8%, respectively.


CONCLUSIONS
Both qualitative and quantitative analysis with CEUS are valuable in the differential diagnosis of hypoechoic renal AMLs from ccRCCs.
Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Qing
Q
Lu
Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Bei-jian
BJ
Huang
Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Wen-ping
WP
Wang
Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Cui-xian
CX
Li
Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Li-yun
LY
Xue
D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D007802:Language; D008067:Lipoma / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D003287:Contrast Media
Angiomyolipoma; Contrast-enhanced ultrasonography; Minimal fat; Quantitative analysis; Renal cell carcinoma