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Published in: Abdominal Radiology 6/2010

01-12-2010

Renal cell carcinoma: real-time contrast-enhanced ultrasound findings

Authors: Zuo-Feng Xu, Hui-Xiong Xu, Xiao-Yan Xie, Guang-Jian Liu, Yan-Ling Zheng, Jin-Yu Liang, Ming-De Lu

Published in: Abdominal Radiology | Issue 6/2010

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Abstract

Objective

To investigate the findings of renal cell carcinomas (RCCs) on contrast-enhanced ultrasound (CEUS).

Methods

CEUS features of 84 RCCs confirmed by pathologic examination in 81 patients were retrospectively analyzed. A contrast-specific mode and a sulfur hexafluoride-filled microbubble contrast agent were used for CEUS. The enhancement pattern, extent, and dynamic change in the cortical, corticomedullary, and late phases were evaluated.

Results

On CEUS, the emergence of tumor enhancement was earlier in two nodules (2.4%), simultaneous in 71 (84.5%), and later in 11 (13.1%), in comparison with the adjacent renal cortex. Seventy-four RCC nodules (88.1%) showed hyper-enhancement (n = 2) or iso-enhancement (n = 72) during the cortical phase, and the remaining 10 (11.9%) showed hypo-enhancement. Twenty-three nodules (27.4%) showed homogeneous enhancement and 61 (72.6%) inhomogeneous enhancement. In the corticomedullary phase, the nodules showed hypo-enhancement in 68 (81.0%) and iso-enhancement in 16 (19.0%). In the late phase, all RCCs showed the same enhancement pattern as that shown in the corticomedullary phase. Seventy-two (85.7%) nodules showed a clear perilesional rim-like enhancement in late phase.

Conclusions

Hyper- or iso-enhancement during the cortical phase, subsequent washout in late phase, inhomogeneous enhancement, and perilesional rim-like enhancement are clues for RCCs, which might be useful for characterization of RCCs.
Literature
1.
go back to reference Heidenreich A, Ravery V (2004) Preoperative imaging in renal cell cancer. World J Urol 22:307–315CrossRefPubMed Heidenreich A, Ravery V (2004) Preoperative imaging in renal cell cancer. World J Urol 22:307–315CrossRefPubMed
2.
go back to reference Wink MH, de la Rosette JJ, Laguna P, et al. (2007) Ultrasonography of renal masses using contrast pulse sequence imaging: a pilot study. J Endourol 21:466–472CrossRefPubMed Wink MH, de la Rosette JJ, Laguna P, et al. (2007) Ultrasonography of renal masses using contrast pulse sequence imaging: a pilot study. J Endourol 21:466–472CrossRefPubMed
3.
go back to reference Mitterberger M, Pelzer A, Colleselli D, et al. (2007) Contrast-enhanced ultrasound for diagnosis of prostate cancer and kidney lesions. Eur J Radiol 64:231–238CrossRefPubMed Mitterberger M, Pelzer A, Colleselli D, et al. (2007) Contrast-enhanced ultrasound for diagnosis of prostate cancer and kidney lesions. Eur J Radiol 64:231–238CrossRefPubMed
4.
go back to reference Claudon M, Cosgrove D, Albrecht T, et al. (2008) Guidelines and good clinical practice recommendations for the contrast enhanced ultrasound (CEUS)-update 2008. Ultraschall Med 29:28–44CrossRefPubMed Claudon M, Cosgrove D, Albrecht T, et al. (2008) Guidelines and good clinical practice recommendations for the contrast enhanced ultrasound (CEUS)-update 2008. Ultraschall Med 29:28–44CrossRefPubMed
5.
go back to reference Nilsson A (2004) Contrast-enhanced ultrasound of kidneys. Eur Radiol 14(Suppl 8):P104–P109PubMed Nilsson A (2004) Contrast-enhanced ultrasound of kidneys. Eur Radiol 14(Suppl 8):P104–P109PubMed
6.
go back to reference Tamai H, Takiguchi Y, Oka M, et al. (2005) Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med 24:1635–1640PubMed Tamai H, Takiguchi Y, Oka M, et al. (2005) Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med 24:1635–1640PubMed
7.
go back to reference Setola SV, Catalano O, Sandomenico F, et al. (2007) Contrast-enhanced sonography of the kidney. Abdom Imaging 32:21–28CrossRefPubMed Setola SV, Catalano O, Sandomenico F, et al. (2007) Contrast-enhanced sonography of the kidney. Abdom Imaging 32:21–28CrossRefPubMed
8.
go back to reference Quaia E, Calliada F, Bertolotto M, et al. (2004) Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology 232:420–430CrossRefPubMed Quaia E, Calliada F, Bertolotto M, et al. (2004) Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology 232:420–430CrossRefPubMed
9.
go back to reference Bleuzen A, Tranquart F (2004) Incidental liver lesions: diagnostic value of cadence contrast pulse sequencing (CPS) and SonoVue. Eur Radiol 14:53–62CrossRef Bleuzen A, Tranquart F (2004) Incidental liver lesions: diagnostic value of cadence contrast pulse sequencing (CPS) and SonoVue. Eur Radiol 14:53–62CrossRef
10.
go back to reference Albrecht T, Blomley M, Bolondi L, et al. (2004) Guidelines for the use of contrast agents in ultrasound. Ultraschall Med 25:249–256CrossRefPubMed Albrecht T, Blomley M, Bolondi L, et al. (2004) Guidelines for the use of contrast agents in ultrasound. Ultraschall Med 25:249–256CrossRefPubMed
11.
go back to reference Ascenti G, Gaeta M, Magno C, et al. (2004) Contrast-enhanced second-harmonic sonography in the detection of pseudocapsule in renal cell carcinoma. AJR Am J Roentgenol 182:1525–1530PubMed Ascenti G, Gaeta M, Magno C, et al. (2004) Contrast-enhanced second-harmonic sonography in the detection of pseudocapsule in renal cell carcinoma. AJR Am J Roentgenol 182:1525–1530PubMed
13.
go back to reference Forman HP, Middleton WD, Melson GL, et al. (1993) Hyperechoic renal cell carcinoma: increase in detection at US. Radiology 188:431–434PubMed Forman HP, Middleton WD, Melson GL, et al. (1993) Hyperechoic renal cell carcinoma: increase in detection at US. Radiology 188:431–434PubMed
14.
go back to reference Jinzaki M, Tanimoto A, Narimatsu Y, et al. (1997) Angiomyolipoma: imaging findings in lesions with minimal fat. Radiology 205:497–502PubMed Jinzaki M, Tanimoto A, Narimatsu Y, et al. (1997) Angiomyolipoma: imaging findings in lesions with minimal fat. Radiology 205:497–502PubMed
15.
go back to reference Ascenti G, Zimbaro G, Mazziotti S, et al. (2001) Usefulness of power Doppler and contrast-enhanced sonography in the differentiation of hyperechoic renal masses. Abdom Imaging 26:654–660CrossRefPubMed Ascenti G, Zimbaro G, Mazziotti S, et al. (2001) Usefulness of power Doppler and contrast-enhanced sonography in the differentiation of hyperechoic renal masses. Abdom Imaging 26:654–660CrossRefPubMed
16.
go back to reference Brannigan M, Burns PN, Wilson SR (2004) Blood flow patterns in focal liver lesions at microbubble-enhanced US. RadioGraphics 24:921–935CrossRefPubMed Brannigan M, Burns PN, Wilson SR (2004) Blood flow patterns in focal liver lesions at microbubble-enhanced US. RadioGraphics 24:921–935CrossRefPubMed
17.
go back to reference Isozaki T, Numata K, Kiba T, et al. (2003) Differential diagnosis of hepatic tumors by using contrast enhancement patterns at US. Radiology 229:798CrossRefPubMed Isozaki T, Numata K, Kiba T, et al. (2003) Differential diagnosis of hepatic tumors by using contrast enhancement patterns at US. Radiology 229:798CrossRefPubMed
18.
19.
go back to reference Park BK, Kim B, Kim SH, et al. (2007) Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol 61:310–314CrossRefPubMed Park BK, Kim B, Kim SH, et al. (2007) Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol 61:310–314CrossRefPubMed
20.
go back to reference Ascenti G, Mazziotti S, Zimbaro G, et al. (2007) Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 243:158–165CrossRefPubMed Ascenti G, Mazziotti S, Zimbaro G, et al. (2007) Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 243:158–165CrossRefPubMed
21.
go back to reference Wang JR, Miao LY, Cui LG, et al. (2008) Application of contrast-enhanced ultrasound in the diagnosis of renal cystic lesion [in Chinese]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 30:22–26 (in Chinese)PubMed Wang JR, Miao LY, Cui LG, et al. (2008) Application of contrast-enhanced ultrasound in the diagnosis of renal cystic lesion [in Chinese]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 30:22–26 (in Chinese)PubMed
22.
go back to reference Yang B, Fu NH, Shen DJ, et al. (2007) Contrast-enhanced ultrasound in the characteristics of renal tumors. Chin J Ultrasonogr 16:599–601 (in Chinese) Yang B, Fu NH, Shen DJ, et al. (2007) Contrast-enhanced ultrasound in the characteristics of renal tumors. Chin J Ultrasonogr 16:599–601 (in Chinese)
23.
go back to reference Tranquart F, Correas JM, Martegani A, et al. (2004) Feasibility of real time contrast enhanced ultrasound in renal disease. J Radiol 85:31–36PubMed Tranquart F, Correas JM, Martegani A, et al. (2004) Feasibility of real time contrast enhanced ultrasound in renal disease. J Radiol 85:31–36PubMed
24.
go back to reference Pallwein L, Mitterberger M, Aigner F, et al. (2007) Small renal masses: the value of contrast-enhanced colour Doppler imaging. BJU Int 99:579–585CrossRefPubMed Pallwein L, Mitterberger M, Aigner F, et al. (2007) Small renal masses: the value of contrast-enhanced colour Doppler imaging. BJU Int 99:579–585CrossRefPubMed
25.
go back to reference Yamashita Y, Honda S, Nishiharu T, et al. (1996) Detection of pseudocapsule of renal cell carcinoma with MR imaging and CT. AJR Am J Roentgenol 166:1151–1155PubMed Yamashita Y, Honda S, Nishiharu T, et al. (1996) Detection of pseudocapsule of renal cell carcinoma with MR imaging and CT. AJR Am J Roentgenol 166:1151–1155PubMed
26.
go back to reference Pickhardt PJ, Lonergan GJ, Davis CJ, et al. (2000) Infiltrative renal lesions: radiologic-pathologic correlation. RadioGraphics 20:215–253PubMed Pickhardt PJ, Lonergan GJ, Davis CJ, et al. (2000) Infiltrative renal lesions: radiologic-pathologic correlation. RadioGraphics 20:215–253PubMed
27.
go back to reference Takahashi S, Ueda J, Furukawa T, et al. (1996) Renal cell carcinoma: preoperative assessment for enucleative surgery with angiography, CT, and MRI. J Comput Assist Tomogr 20:863–869CrossRefPubMed Takahashi S, Ueda J, Furukawa T, et al. (1996) Renal cell carcinoma: preoperative assessment for enucleative surgery with angiography, CT, and MRI. J Comput Assist Tomogr 20:863–869CrossRefPubMed
28.
go back to reference Pretorius ES, Siegelman ES, Ramchandani P, et al. (1999) Renal neoplasm amenable to partial nephrectomy: MR imaging. Radiology 212:28–34PubMed Pretorius ES, Siegelman ES, Ramchandani P, et al. (1999) Renal neoplasm amenable to partial nephrectomy: MR imaging. Radiology 212:28–34PubMed
29.
go back to reference Haendl T, Strobel D, Legal W, et al. (2009) Renal cell cancer does not show a typical perfusion pattern in contrast-enhanced ultrasound. Ultraschall Med 30:58–63 (in German)CrossRefPubMed Haendl T, Strobel D, Legal W, et al. (2009) Renal cell cancer does not show a typical perfusion pattern in contrast-enhanced ultrasound. Ultraschall Med 30:58–63 (in German)CrossRefPubMed
30.
go back to reference Quaia E, Siracusano S, Bertolotto M, et al. (2003) Characterization of renal tumours with pulse inversion harmonic imaging by intermittent high mechanical index technique: initial results. Eur Radiol 13:1402–1412PubMed Quaia E, Siracusano S, Bertolotto M, et al. (2003) Characterization of renal tumours with pulse inversion harmonic imaging by intermittent high mechanical index technique: initial results. Eur Radiol 13:1402–1412PubMed
31.
go back to reference Li J, Dong BW, Yu XL, et al. (2005) Time–intensity based quantification of vascularity with single-level dynamic contrast-enhanced ultrasonography: a pilot animal study. J Ultrasound Med 24:975–983PubMed Li J, Dong BW, Yu XL, et al. (2005) Time–intensity based quantification of vascularity with single-level dynamic contrast-enhanced ultrasonography: a pilot animal study. J Ultrasound Med 24:975–983PubMed
Metadata
Title
Renal cell carcinoma: real-time contrast-enhanced ultrasound findings
Authors
Zuo-Feng Xu
Hui-Xiong Xu
Xiao-Yan Xie
Guang-Jian Liu
Yan-Ling Zheng
Jin-Yu Liang
Ming-De Lu
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Abdominal Radiology / Issue 6/2010
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-009-9583-y

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