Évaluation de l’apport de l’échographie de contraste dans l’analyse des kystes rénaux de nature indéterminée au scanner

Abstract

Purpose

To demonstrate the value of contrast-enhanced ultrasound (CEUS) in the management of Bosniak type 2F and 3 renal cysts on CT.

Patients and methods

Retrospective study of 14 patients with 15 Bosniak type 2F and 3 renal cysts on contrast enhanced CT. All patients underwent CEUS of the kidneys after injection of SonoVue^®. Using predetermined criteria, the lesions were classified as benign, malignant or indeterminate. Patients either underwent surgery or follow-up CT at one to three years.

Results

From the 15 indeterminate cysts on CT, 12 were either benign (n = 8) or malignant (n = 4) on CEUS. From the eight cysts considered benign on CEUS, seven remained stable on follow-up CT after a minimum of one year interval and one was surgically resected and confirmed to be benign. All four cysts considered malignant on CEUS were surgically resected and three were confirmed to be malignant and one was confirmed to be benign. Three cysts were indeterminate: two lesions were surgically resected and one was benign while the other was malignant and one lesion was stable at one year follow-up CT.

Conclusion

CEUS was able to characterize indeterminate lesions as benign or malignant in 80% of cases with 92% reliability. Twenty percent of cysts remained indeterminate on CEUS. CEUS is reliable as a complement to CT in the evaluation of Bosniak type 2F and 3 renal cysts.