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Klinische Wertigkeit des kontrastmittelverstärkten Ultraschalls in der Diagnostik von Nierenraumforderungen
Klinische Wertigkeit des kontrastmittelverstärkten Ultraschalls in der Diagnostik von Nierenraumforderungen
Background The number of cystic kidney lesions discovered has incidentally increased constantly over the past few decades due to increased imaging. Renal cell carcinoma, the most common malignant kidney tumor, has a good prognosis if it is detected early and can be surgically resected. The reliable differentiation of unclear kidney lesions through imaging has outmost importance. Objective The aim of this work is to determine the diagnostic accuracy of contrast-enhanced ultrasound examinations in the differentiation of unclear renal masses. Methods Patients who received a CEUS examination in the period from 2005 to 2020 for an unclear renal mass with a histopathological finding, as the reference standard, were statistically analyzed in a retrospective data analysis. Results In 394 patients there were histopathological findings for correlation with the CEUS findings. A total of 300 malignant and 94 benign renal lesions were identified. The study population averaged 63 years old and 70.1 % were male. The CEUS investigation shows a sensitivity of 95.3 %, a specificity of 41.5 %, a positive predictive value of 83.9 % and a negative predictive value of 73.6 %. Summary The CEUS examination has a high sensitivity in differentiating between malignant and benign renal masses and represents an inexpensive, radiation-free alternative or additive imaging. CEUS is the imaging of choice for follow-up examinations of Bosniak 2F kidney cysts and for cases with contraindications for CT or MRI examinations.
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Müller, Philipp
2022
German
Universitätsbibliothek der Ludwig-Maximilians-Universität München
Müller, Philipp (2022): Klinische Wertigkeit des kontrastmittelverstärkten Ultraschalls in der Diagnostik von Nierenraumforderungen. Dissertation, LMU München: Faculty of Medicine
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Abstract

Background The number of cystic kidney lesions discovered has incidentally increased constantly over the past few decades due to increased imaging. Renal cell carcinoma, the most common malignant kidney tumor, has a good prognosis if it is detected early and can be surgically resected. The reliable differentiation of unclear kidney lesions through imaging has outmost importance. Objective The aim of this work is to determine the diagnostic accuracy of contrast-enhanced ultrasound examinations in the differentiation of unclear renal masses. Methods Patients who received a CEUS examination in the period from 2005 to 2020 for an unclear renal mass with a histopathological finding, as the reference standard, were statistically analyzed in a retrospective data analysis. Results In 394 patients there were histopathological findings for correlation with the CEUS findings. A total of 300 malignant and 94 benign renal lesions were identified. The study population averaged 63 years old and 70.1 % were male. The CEUS investigation shows a sensitivity of 95.3 %, a specificity of 41.5 %, a positive predictive value of 83.9 % and a negative predictive value of 73.6 %. Summary The CEUS examination has a high sensitivity in differentiating between malignant and benign renal masses and represents an inexpensive, radiation-free alternative or additive imaging. CEUS is the imaging of choice for follow-up examinations of Bosniak 2F kidney cysts and for cases with contraindications for CT or MRI examinations.