Ces radiol. 2014, 68(1):30-39

Comparison of contrast-enhanced ultrasonography and CT in the classification of renal cystic lesionsOriginal article

Jakub Foukal¹, Marek Mechl¹, Eva Janoušová²

¹ Radiologická klinika LF MU a FN, Brno

² Institut biostatistiky a analýz LF MU, Brno

Aim: To evaluate the classification of cystic renal lesions with CEUS and compare the results with CT.

Method: The set consists of 112 lesions in 94 patients who had renal lesion on CEUS and CT with cystic appearance on at least one of the methods. Lesions were evaluated by Bosniak classification and either histologically verified or followed-up for at least two years.
We assessed correlation between methods, sensitivity and specificity for detection of features used in Bosniak classification, sensitivity and specificity for malignancy from the viewpoint of Bosniak classification and that of individual features. Data were processed by ROC analysis. Statistical significance was assessed by Fisher's exact test.

Results: Overall agreement between methods was 61%, with division to non-surgical (category I, II, IIF) and surgical (III, IV, solid) lesions agreement was 90%. With this division sensitivity was 92.3% for CEUS, 69.2% for CT, specificity 90.9% for CEUS and 94.9% for CT.
CEUS was more sensitive than CT in detecting septa (53% vs. 25% of lesions; p < 0.001) and in detecting enhancement of septa (22% vs. 10% of lesions; p = 0,006). Detection of enhancement of solid component was not significantly different, but on CEUS it was more important factor for malignancy detection (increased likelihood of malignancy 384 times on CEUS, 78 times on CT, p < 0.001).

Conclusion: Results of CEUS correlate with CT. Sensitivity of CEUS for the detection of malignancy is higher than that of CT, specificity is slightly lower.

Keywords: renal cysts, Bosniak classification, CEUS, CT, renal cell carcinoma

Grants and funding:

Podpořeno projektem Ministerstva zdravotnictví ČR Koncepčního rozvoje výzkumné organizace 65269705 (FN Brno).

Accepted: July 31, 2013; Published: March 1, 2014  Show citation