Contrast enhanced multiparametric ultrasound of solid kidney lesions in comparison with the computed tomography

Abstract

Introduction. Today, we have a lot of difficulties in the focal kidney lesions diagnosis, despite the many available radiation methods of examination. Computed tomography (CT) is the «gold standard» of radiological diagnosis of kidney cancer (KC), which over the years of its existence has proven to be highly effectiveness. Ultrasound examination (US) is the best method for the primary diagnosis of solid kidney lesions. Multiparameter ultrasound (mpUS) with using contrast significantly supplements the information obtained in traditional scanning, significantly expanding the range of tasks to be solved. The article discusses the modern possibilities of radiology methods in the detection and assessment of kidney lesions, their role in determining the patient management tactics.Objective. Тo explore the possibilities and compare the effectiveness of individual multiparameter ultrasound techniques (Bmode, CDI and PDI, ultrasoundcontrast) in assessing solid kidney formations with each other and computed tomography (CT), as a reference method of radiation diagnostics.Material and methods. Мultiparametric ultrasound examination (mpUS) using B-mode, doppler mapping and contrast enhancement (1,0 ml Sonovue) was performed in 79 patients with solid kidney lesions. Most of the detected lesions (n=65) were histologically verified, the rest (n=14) with signs of benign changes were subjected to dynamic control. All patients underwent contrast-enhanced computed tomography as a control method.Results. Тhe effectiveness of the B-mode was: sensitivity (Se) — 76,9%; specificity (Sp) — 29,6%; accuracy (A) — 60,7%, for the CDI mode, these indicators were Se — 80,7%; Sp — 37,1%; A — 65,8%. The use of contrast enhancement significantly increased the overall efficiency of multiparameter ultrasound: Se — 92,1%; Sp — 93,7%; A — 92,4% and showed comparable efficiency with CT: Sp — 94,9%; Se — 85,0%; A — 92,4%.Conclusions. CT to this day remains the «gold standard» in the assessment of kidney lesions, however, ultrasound with contrast enhancement due to comparable efficiency, as well as taking into account the absence of radiation exposure, wide availability of equipment, high resolution, in the presence of contraindications to CT in a number of cases can act as a method of choice.