Ying Li, Luo Li, Li Fang, Zhou Hang, Tao Xueshuang, Ling Yun
Department of Ultrasound, Chongqing Cancer Hospital, Chongqing, China.
Curr Med Imaging. 2024;20:e15734056244999. doi: 10.2174/0115734056244999231124113017.
Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare benign lesion that appears as a solid cystic renal lesion or complex renal cystic lesion on medical imaging. There are no definite imaging criteria for METSK diagnosis.
We present a case of a solid cystic renal mass that was evaluated by contrast-enhanced ultrasound (CEUS) during an imaging workup. The patient underwent nephrectomy and histopathological confirmation of MESTK. The lesions showed hypoenhancement during the process. Quantitative perfusion analysis showed the septation of the solid cystic lesion to have lower peak enhancement with a longer rise time compared to the normal renal cortex.
CEUS can visualize the microcirculation of the organ and reconstruction of the vessels. By providing a more detailed visualization of the microvessel, CEUS is a useful tool for further characterizing renal lesions that show indeterminate enhancement on CT. This study determined the time to peak to be shorter for the cancerous lesion than the normal renal cortex, while peak intensity did not differ between the cancerous lesion and the normal renal cortex.
Quantitative perfusion analysis of CEUS may be useful for differentiating benign and malignant solid cystic renal masses. Further investigation is needed to determine whether peak intensity is a useful parameter in differentiating benign and malignant solid cystic lesions of the kidney.
肾脏混合性上皮和间质肿瘤（MESTK）是一种罕见的良性病变，在医学影像上表现为实性囊性肾病变或复杂性肾囊性病变。目前尚无明确的METSK诊断影像学标准。
我们报告一例实性囊性肾肿块病例，在影像学检查过程中通过对比增强超声（CEUS）进行评估。患者接受了肾切除术，病理组织学确诊为MESTK。病变在此过程中表现为低增强。定量灌注分析显示，与正常肾皮质相比，实性囊性病变的分隔具有较低的峰值增强和较长的上升时间。
CEUS可以显示器官的微循环和血管重建。通过更详细地显示微血管，CEUS是进一步鉴别CT上增强表现不明确的肾病变的有用工具。本研究确定癌性病变的达峰时间比正常肾皮质短，而癌性病变与正常肾皮质之间的峰值强度无差异。
CEUS的定量灌注分析可能有助于鉴别良性和恶性实性囊性肾肿块。需要进一步研究以确定峰值强度是否是鉴别肾良性和恶性实性囊性病变的有用参数。
