Slowly but Surely - Contrast Enhanced Ultrasound (CEUS) for indeterminate renal lesions

Steven Kennish, Sheffield Teaching Hospitals NHS Foundation Trust

Background and Aims

The majority of renal lesions can be confidently evaluated on conventional ultrasound (US) and pre and post contrast computed tomography (CT) or magnetic resonance imaging (MRI). Difficulty in excluding the malignant potential of a subset of renal lesions is often related to equivocal objective assessment of vascularisation assessed by colour flow on US or contrast enhancement on CT/MRI, particularly when attempting to differentiate hypovascular solid lesions from hyperdense cysts. Given the excellent sensitivity in relation to microvascular flow, CEUS has the potential to add further diagnostic clarity for these indeterminate lesions (Tedesco et al, 2018). At our institution CEUS has been reserved for evaluating indeterminate renal lesions on US/CT/MRI or for evaluating renal lesions in patients with significant renal impairment precluding CT or MRI contrast agent administration. It is important to establish the added value of CEUS for those patients undergoing this additional test.

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