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World J Radiol. Jan 28, 2010; 2(1): 15-31
Published online Jan 28, 2010. doi: 10.4329/wjr.v2.i1.15
Contrast enhanced ultrasound of renal masses
Andre Ignee, Bernd Straub, Gudrun Schuessler, Christoph Frank Dietrich
Andre Ignee, Gudrun Schuessler, Christoph Frank Dietrich, 2nd Department of Internal Medicine, Caritas Krankenhaus, Uhlandstrasse 7, 97980 Bad Mergentheim, Germany
Bernd Straub, Department of Urology, Caritas Krankenhaus, 97980 Bad Mergentheim, Germany
Author contributions: All authors contributed to this article.
Correspondence to: Christoph Frank Dietrich, Professor, 2nd Department of Internal Medicine, Caritas Krankenhaus, Uhlandstrasse 7, 97980 Bad Mergentheim, Germany.
Telephone: +49-7931-582201 Fax: +49-7931-582290
Received: December 19, 2009
Revised: January 20, 2010
Accepted: January 22, 2010
Published online: January 28, 2010

Contrast enhanced ultrasound (CEUS) has gained clinical importance over the last years for the characterization of hepatic masses. Its role in extrahepatic indications has been investigated repeatedly but has been less comprehensively studied. Currently more than 50% of renal masses are incidentally diagnosed, mostly by B-mode ultrasound. The method of choice for characterization of renal lesions is contrast enhanced computed tomography (CECT). In the case of cystic lesions CECT refers to the Bosniak classification for cystic lesions to assess the risk of malignant behavior. The majority of masses are renal cell carcinoma, but the exact proportion is controversial. Disadvantages of CECT are a significant risk for patients with impaired renal function, allergic reactions and hyperthyroidism due to iodinated contrast agents. Several studies concerning CEUS for the characterization of both solid and cystic renal lesions have been published, but prospective multicenter studies are missing, the presented data being mainly descriptive. The aim of the this manuscript is to review the current literature for CEUS in renal masses, to summarize the available data and focus on possible concepts for studies in the future.

Keywords: Contrast enhanced ultrasound, Renal cell carcinoma, Angiomyolipoma, Oncocytoma, Sonovue, Biopsy