DOI QR코드

DOI QR Code

Qualitative and Quantitative Analysis with Contrast-Enhanced Ultrasonography: Diagnosis Value in Hypoechoic Renal Angiomyolipoma

  • Lu, Qing (Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University) ;
  • Huang, Bei-jian (Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University) ;
  • Wang, Wen-ping (Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University) ;
  • Li, Cui-xian (Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University) ;
  • Xue, Li-yun (Shanghai Imaging Institute of Medicine, Department of Ultrasound, Zhongshan Hospital, Fudan University)
  • 투고 : 2014.07.31
  • 심사 : 2014.12.15
  • 발행 : 2015.04.01

초록

Objective: To evaluate the value of enhancement features and quantitative parameters of contrast-enhanced ultrasonography (CEUS) in differentiating solid hypoechoic renal angiomyolipomas (AMLs) from clear cell renal cell carcinomas (ccRCCs). Materials and Methods: We analyzed the enhancement features and quantitative parameters of CEUS in 174 hypoechoic renal masses (32 AMLs and 142 ccRCCs) included in the study. Results: Centripetal enhancement pattern was more common in AMLs than in ccRCCs on CEUS (71.9% vs. 23.2%, p < 0.001). At peak enhancement, all AMLs showed homogeneous enhancement (100% in AML, 27.5% in ccRCCs; p < 0.001). Quantitative analysis showed no significant difference between rise time and time to peak. Tumor-to-cortex (TOC) enhancement ratio in AMLs was significantly lower than that in ccRCCs (p < 0.001). The criteria of centripetal enhancement and homogeneous peak enhancement together with TOC ratio < 91.0% used to differentiate hypoechoic AMLs from ccRCCs resulted in a sensitivity and specificity of 68.9% and 95.8%, respectively. Conclusion: Both qualitative and quantitative analysis with CEUS are valuable in the differential diagnosis of hypoechoic renal AMLs from ccRCCs.

키워드

참고문헌

  1. Hartman DS, Goldman SM, Friedman AC, Davis CJ Jr, Madewell JE, Sherman JL. Angiomyolipoma: ultrasonic-pathologic correlation. Radiology 1981;139:451-458 https://doi.org/10.1148/radiology.139.2.7220890
  2. Halpenny D, Snow A, McNeill G, Torreggiani WC. The radiological diagnosis and treatment of renal angiomyolipomacurrent status. Clin Radiol 2010;65:99-108 https://doi.org/10.1016/j.crad.2009.09.014
  3. Lu Q, Wang W, Huang B, Li C, Li C. Minimal fat renal angiomyolipoma: the initial study with contrast-enhanced ultrasonography. Ultrasound Med Biol 2012;38:1896-1901 https://doi.org/10.1016/j.ultrasmedbio.2012.07.014
  4. Aydin H, Magi-Galluzzi C, Lane BR, Sercia L, Lopez JI, Rini BI, et al. Renal angiomyolipoma: clinicopathologic study of 194 cases with emphasis on the epithelioid histology and tuberous sclerosis association. Am J Surg Pathol 2009;33:289-297 https://doi.org/10.1097/PAS.0b013e31817ed7a6
  5. Serrano Frago P, Del Agua Arias Camison C, Gil Sanz MJ, Allue Lopez M, Gonzalvo Ibarra A, Plaza Mas L, et al. Controversies related to epithelioid variant of renal angiomyolipoma: a review of the literature. Urology 2006;67:846.e3-846.e5
  6. Xu ZF, Xu HX, Xie XY, Liu GJ, Zheng YL, Lu MD. Renal cell carcinoma and renal angiomyolipoma: differential diagnosis with real-time contrast-enhanced ultrasonography. J Ultrasound Med 2010;29:709-717 https://doi.org/10.7863/jum.2010.29.5.709
  7. Ascenti G, Gaeta M, Magno C, Mazziotti S, Blandino A, Melloni D, et al. Contrast-enhanced second-harmonic sonography in the detection of pseudocapsule in renal cell carcinoma. AJR Am J Roentgenol 2004;182:1525-1530 https://doi.org/10.2214/ajr.182.6.1821525
  8. Pretorius ES, Siegelman ES, Ramchandani P, Cangiano T, Banner MP. Renal neoplasms amenable to partial nephrectomy: MR imaging. Radiology 1999;212:28-34 https://doi.org/10.1148/radiology.212.1.r99jl3228
  9. Ignee A, Jedrejczyk M, Schuessler G, Jakubowski W, Dietrich CF. Quantitative contrast enhanced ultrasound of the liver for time intensity curves-reliability and potential sources of errors. Eur J Radiol 2010;73:153-158 https://doi.org/10.1016/j.ejrad.2008.10.016
  10. Raj GV, Bach AM, Iasonos A, Korets R, Blitstein J, Hann L, et al. Predicting the histology of renal masses using preoperative Doppler ultrasonography. J Urol 2007;177:53-58 https://doi.org/10.1016/j.juro.2006.08.067
  11. Milner J, McNeil B, Alioto J, Proud K, Rubinas T, Picken M, et al. Fat poor renal angiomyolipoma: patient, computerized tomography and histological findings. J Urol 2006;176:905-909 https://doi.org/10.1016/j.juro.2006.04.016
  12. Sasiwimonphan K, Takahashi N, Leibovich BC, Carter RE, Atwell TD, Kawashima A. Small (< 4 cm) renal mass: differentiation of angiomyolipoma without visible fat from renal cell carcinoma utilizing MR imaging. Radiology 2012;263:160-168 https://doi.org/10.1148/radiol.12111205
  13. Pysz MA, Guracar I, Foygel K, Tian L, Willmann JK. Quantitative assessment of tumor angiogenesis using realtime motion-compensated contrast-enhanced ultrasound imaging. Angiogenesis 2012;15:433-442 https://doi.org/10.1007/s10456-012-9271-3
  14. Goertz RS, Bernatik T, Strobel D, Hahn EG, Haendl T. Softwarebased quantification of contrast-enhanced ultrasound in focal liver lesions--a feasibility study. Eur J Radiol 2010;75:e22-e26
  15. Aoki S, Hattori R, Yamamoto T, Funahashi Y, Matsukawa Y, Gotoh M, et al. Contrast-enhanced ultrasound using a timeintensity curve for the diagnosis of renal cell carcinoma. BJU Int 2011;108:349-354 https://doi.org/10.1111/j.1464-410X.2010.09799.x
  16. Tsai CC, Wu WJ, Li CC, Wang CJ, Wu CH, Wu CC. Epithelioid angiomyolipoma of the kidney mimicking renal cell carcinoma: a clinicopathologic analysis of cases and literature review. Kaohsiung J Med Sci 2009;25:133-140 https://doi.org/10.1016/S1607-551X(09)70052-X
  17. Park BK, Kim SH, Choi HJ. Characterization of renal cell carcinoma using agent detection imaging: comparison with gray-scale US. Korean J Radiol 2005;6:173-178 https://doi.org/10.3348/kjr.2005.6.3.173
  18. Jiang J, Chen Y, Zhou Y, Zhang H. Clear cell renal cell carcinoma: contrast-enhanced ultrasound features relation to tumor size. Eur J Radiol 2010;73:162-167 https://doi.org/10.1016/j.ejrad.2008.09.030
  19. Dong XQ, Shen Y, Xu LW, Xu CM, Bi W, Wang XM. Contrastenhanced ultrasound for detection and diagnosis of renal clear cell carcinoma. Chin Med J (Engl) 2009;122:1179-1183
  20. Gerst S, Hann LE, Li D, Gonen M, Tickoo S, Sohn MJ, et al. Evaluation of renal masses with contrast-enhanced ultrasound: initial experience. AJR Am J Roentgenol 2011;197:897-906 https://doi.org/10.2214/AJR.10.6330
  21. Yamashita Y, Honda S, Nishiharu T, Urata J, Takahashi M. Detection of pseudocapsule of renal cell carcinoma with MR imaging and CT. AJR Am J Roentgenol 1996;166:1151-1155 https://doi.org/10.2214/ajr.166.5.8615260
  22. Ruppert-Kohlmayr AJ, Uggowitzer M, Meissnitzer T, Ruppert G. Differentiation of renal clear cell carcinoma and renal papillary carcinoma using quantitative CT enhancement parameters. AJR Am J Roentgenol 2004;183:1387-1391 https://doi.org/10.2214/ajr.183.5.1831387
  23. Sheir KZ, El-Azab M, Mosbah A, El-Baz M, Shaaban AA. Differentiation of renal cell carcinoma subtypes by multislice computerized tomography. J Urol 2005;174:451-455; discussion 455 https://doi.org/10.1097/01.ju.0000165341.08396.a9
  24. Siracusano S, Quaia E, Bertolotto M, Ciciliato S, Tiberio A, Belgrano E. The application of ultrasound contrast agents in the characterization of renal tumors. World J Urol 2004;22:316-322 https://doi.org/10.1007/s00345-004-0410-3
  25. Zhang J, Lefkowitz RA, Ishill NM, Wang L, Moskowitz CS, Russo P, et al. Solid renal cortical tumors: differentiation with CT. Radiology 2007;244:494-504 https://doi.org/10.1148/radiol.2442060927
  26. Pedrosa I, Chou MT, Ngo L, H Baroni R, Genega EM, Galaburda L, et al. MR classification of renal masses with pathologic correlation. Eur Radiol 2008;18:365-375 https://doi.org/10.1007/s00330-007-0757-0
  27. Kim JK, Kim TK, Ahn HJ, Kim CS, Kim KR, Cho KS. Differentiation of subtypes of renal cell carcinoma on helical CT scans. AJR Am J Roentgenol 2002;178:1499-1506 https://doi.org/10.2214/ajr.178.6.1781499

피인용 문헌

  1. What's new in urologic ultrasound? vol.31, pp.3, 2015, https://doi.org/10.4103/0970-1591.159604
  2. Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation? vol.17, pp.5, 2016, https://doi.org/10.3348/kjr.2016.17.5.706
  3. DIAGNOSTIC IMAGING OF SMALL RENAL MASSES vol.55, pp.3, 2015, https://doi.org/10.5633/amm.2016.0309
  4. Selection and Reporting of Statistical Methods to Assess Reliability of a Diagnostic Test: Conformity to Recommended Methods in a Peer-Reviewed Journal vol.18, pp.6, 2017, https://doi.org/10.3348/kjr.2017.18.6.888
  5. Two in One: Epithelioid angiomyolipoma within a classic kidney angiomyolipoma - a case report vol.19, pp.1, 2015, https://doi.org/10.1186/s12882-018-0919-0
  6. Dynamic Contrast-Enhanced Ultrasound of Gastric Cancer: Correlation with Perfusion CT and Histopathology vol.20, pp.5, 2019, https://doi.org/10.3348/kjr.2018.0273
  7. Value of Perfusion Parameters for Differentiating Hepatocellular Carcinoma and Liver Metastasis With Hypervascularity and a Normal Hepatic Background on Contrast‐Enhanced Ultrasound Imaging vol.38, pp.10, 2015, https://doi.org/10.1002/jum.14957
  8. Diagnostic Performance of Contrast-Enhanced Ultrasound in Renal Cancer: A Meta-Analysis vol.10, pp.None, 2015, https://doi.org/10.3389/fonc.2020.586949