Abstract

Unlikely with CECT, CEUS can be applied in patients with renal impairment or allergic reaction. CEUS can be used in cases of renal ischemia, renal infections, renal trauma, for the differentiation of solid renal masses and pseudo-tumors, and for the characterization of complex cystic masses. Renal pseudo-tumors, such as column of Bertin and dromedary hump, can often be evaluated with conventional ultrasound alone. CEUS can be performed directly after the conventional US and may show similar finding of same enhancement pattern as the normal parenchyma. The differentiation of Bosniak IIF and III cystic masses are important in management and prognosis. CEUS is a sensitive method to depict internal enhancement and structure within the cystic masses. Several studies have shown high concordance (74∼86%) between CEUS and CECT in the Bosniak classification of complex renal cysts. CEUS is helpful in detection of small renal masses. Although there remained controversy, several reports suggested usefulness of CEUS in characterization of solid renal tumors. CEUS is also useful in the monitoring of renal lesions treated by percutaneous ablation therapies. The other renal application of CEUS is evaluation of transplanted kidney. CEUS can easily detect vascular problem of transplanted kidneys including aneurysm and infarction. Several studies reported that CEUS in patients with acute rejection may show delayed parenchymal enhancement compared with patients with acute tubular necrosis. The potential further renal applications may include evaluation of vascular or traumatic insults and follow-up after anti-angiogenic therapy of renal tumors.

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