Department of Radiology, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany.
Institute of Pathology, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany.
Scand J Urol. 2020 Apr;54(2):135-140. doi: 10.1080/21681805.2020.1736621. Epub 2020 Mar 12.
The aim of the present retrospective single-center study is to evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the evaluation of renal oncocytoma. Thirteen patients with histopathologically confirmed renal oncocytoma and 26 patients with histopathologically confirmed renal cell carcinoma were included in this retrospective single-center study on whom CEUS was performed between 2005 and 2015. The applied contrast agent was a second-generation blood pool agent. CEUS examinations were performed and interpreted by a single radiologist with more than 15 years of experience (EFSUMB Level 3). CEUS examinations were successfully performed in all included patients without any adverse effects. Renal oncocytomas showed varying echogenicity (46% hypoechoic, 23% hyperechoic, 8% iso-/hyperechoic, 8% isoechoic). In two cases renal oncocytoma only demarcated upon i.v. application of contrast medium. In bilateral oncocytosis, lesions presented as hyperechoic. Only 23% of renal oncocytomas showed slight vascularization using Color Doppler. No oncocytoma-specific pattern of microperfusion could be elucidated: 85% of the oncocytomas presented hyperenhancing, of whom 50% also showed delayed venous wash-out; 8% of renal oncocytomas showed venous wash-out without early arterial hyperenhancement. Within the frame of the present study and in line with the recent state of knowledge, no specific sonomorphological feature - including CEUS - could be detected allowing for adequate discrimination between oncocytoma and renal cell carcinoma.
本回顾性单中心研究的目的是评估对比增强超声(CEUS)在评价肾嗜酸细胞瘤中的诊断性能。该回顾性单中心研究纳入了 13 例经组织病理学证实的肾嗜酸细胞瘤患者和 26 例经组织病理学证实的肾细胞癌患者,这些患者均在 2005 年至 2015 年间接受了 CEUS 检查。所用的对比剂为第二代血池造影剂。CEUS 检查由一位具有 15 年以上经验的放射科医生(EFSUMB 级别 3)进行操作和解释。所有纳入的患者均成功进行了 CEUS 检查,无任何不良反应。肾嗜酸细胞瘤表现出不同的回声强度(46%为低回声,23%为高回声,8%为等/高回声,8%为等回声)。在 2 例肾嗜酸细胞瘤中,仅在静脉应用对比剂后才能清晰显示边界。在双侧嗜酸细胞瘤中,病变表现为高回声。仅 23%的肾嗜酸细胞瘤在彩色多普勒中显示轻度血管化。未能阐明嗜酸细胞瘤的特定微血管灌注模式:85%的嗜酸细胞瘤表现为高增强,其中 50%也表现出延迟的静脉洗脱;8%的肾嗜酸细胞瘤表现为无早期动脉高增强的静脉洗脱。根据本研究和最新知识,在包括 CEUS 在内的声像特征方面,未能检测到足以将嗜酸细胞瘤与肾细胞癌区分开来的特异性特征。