A comparison of radiologic methods in the diagnosis of renal mass lesions.

The reliability of radiologic diagnosis was studied in 99 patients undergoing ultrasonography, computerized tomography and angiography in work up of renal mass lesions. The diagnoses were confirmed by angiography combined with percutaneous puncture or by surgery. Of the lesions, 37 were simple renal cysts and 56 were renal cell carcinomas. Eighty-eight percent were diagnosed correctly by ultrasonography, 96% by computerized tomography and 84% by angiography. The conclusion is that the radiologic evaluation of a renal mass lesion found at urography should start with ultrasonography. Percutaneous puncture is not recommended if all criteria of a simple renal cyst are strictly fulfilled at ultrasonography. In all other cases a computerized tomography is thought to be mandatory to avoid false negative diagnoses of malignant tumours or other diseases which may need therapy. In some patients a combination with angiography and percutaneous puncture is advised to establish a diagnosis prior to surgery.