CEUS-diagnostic workup of cystic renal lesions

Abstract

Cystic renal lesions are common incidental findings in radiological imaging and they should be adequately examined to be able to characterize them as benign or malignant. It is not always possible to sufficiently characterize cystic renal lesion solely using native B‑mode sonography and color-Doppler sonography. Using contrast-enhanced ultrasound (CEUS), it is possible to dynamically evaluate the perfusion of cystic renal lesions and to characterize the potential malignancy of these lesions using the Bosniak classification in order to give recommendations regarding further work-up. CEUS can also be used in patients with contraindications for other radiological imaging modalities as it uses acontrast agent with almost no side effects. Using CEUS, cystic renal lesions can be reliably characterized with adiagnostic accuracy greater than 90%. CEUS is auseful method in diagnosing and characterizing unclear cystic renal lesions and should always be considered as aviable diagnostic tool. CEUS should always be performed in initially unclear cases and is auseful additional tool for the diagnosis and characterization of unclear cystic renal lesions.