Pilot study of three-dimensional contrast-enhanced ultrasound in vascular patterns of renal tumors

Abstract

Objective To evaluate the feasibility of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in showing vascular patterns of renal tumors.Methods The images of 3D-CEUS examination were retrospectively analyzed in one hundred and twenty one renal tumors which were confirmed sequentially by pathology.3D-CEUS was performed after conventional ultrasound and contrast-enhanced ultrasound (CEUS).The 3D-CEUS images were reconstructed by QLAB workstation and classified into 4 grades based on the blood supply characteristics.Results All the tumors were confirmed by pathology and operations,including clear cell renal cell carcinoma (CCRCC) (n=91),papillary renal cell carcinoma (PRCC) (n=5),chromophobe renal cell carcinoma (CRCC) (n=5),renal angiomyolipoma (RAML) (n=19),and cystic nephroma (n=1).Three-dimensional reconstruction could provide clear stereoscopic views of the interested structures and morphological characteristics of lesions.The three-dimensional ultrasonography of a particular renal tumor could be a mixture of different basic grades.There were significant differences between benign and malignant renal tumors in 3D-CEUS.The image quality was the best in early parenchymal phase comparing to other phases.In early parenchymal phase,84 RCCs (83.17%) were tortuous expansive reticular or irregular messy dendritic,61 cases (60.40%) with filling defect areas and 15 cases (14.85%) with pseudocapsules.Grade Ⅲ and Grade Ⅳ were the main vascular patterns in maglinant tumors.In early parenchymal phase,6 RAMLs (31.58%) were nebulous with dendritic in part,12 cases(63.16%) were reticular on the basis of nebulous with homogeneous internal structures.The vascular pattern was shown better in 3D-CEUS than CEUS.Conclusions 3D-CEUS can provide clear stereoscopic structures and morphological characteristics of the lesions,it is a useful adjuvant of CEUS for the diagnosis of renal tumors. Key words: Ultrasonography,three-dimensional; Microbubbles; Kidney neoplasms