CONTRAST HARMONIC ULTRASONOGRAPHIC APPEARANCE OF FOCAL SPACE-OCCUPYING RENAL LESIONS

Authors

  • HENDRIK HAERS,

    1. Department of Veterinary Medical Imaging and Small Animal Orthopedics, Salisburylaan 133, 9820 Merelbeke, Belgium
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  • MASSIMO VIGNOLI,

    1. Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
    2. Veterinary Clinic dell'Orologio, Via Gramsci 1/4, 40037 Sasso Marconi, Bologna, Italy
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  • GEERT PAES,

    1. Department of Small Animal Medicine and Clinical Biology, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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  • FEDERICA ROSSI,

    1. Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
    2. Veterinary Clinic dell'Orologio, Via Gramsci 1/4, 40037 Sasso Marconi, Bologna, Italy
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  • OLIVIER TAEYMANS,

    1. Department of Clinical Sciences, Section of Diagnostic Imaging, Foster Hospital for Small Animals, Cummings School of Veterinary Medicine, Tufts University, 200 Westborough Road North Grafton, MA 01536
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  • SYLVIE DAMINET,

    1. Department of Small Animal Medicine and Clinical Biology, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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  • JIMMY H. SAUNDERS

    1. Department of Veterinary Medical Imaging and Small Animal Orthopedics, Salisburylaan 133, 9820 Merelbeke, Belgium
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  • This project was financially supported by Esaote-PieMedical, Maastricht, the Netherlands.
    Part of this study was presented as a poster presentation at the EVDI Annual Meeting 2008, in Svolvaer, Norway.

Address correspondence and reprint requests to Hendrik Haers, at the above address. E-mail: hendrikhaers@hotmail.com

Abstract

To describe the contrast-enhanced ultrasonographic appearance of various focal, space-occupying renal lesions and determine its value in their detection and characterization. Following baseline B-mode sonography of 15 dogs and one cat with renal space-occupying lesion(s), contrast-enhanced sonography was performed. The resulting images were evaluated qualitatively using conspicuity and number of lesions, and enhancement patterns were assessed during early arterial and late corticomedullary phases. Renal lesions were malignant in the cat (renal cell carcinoma) and 10 dogs (four renal cell carcinoma, two histiocytic sarcoma, one B-cell lymphoma, two hemangiosarcoma metastasis, one chemodectoma metastasis) and benign in five dogs (two abscesses, one traumatic hematoma, one idiopathic hematoma, one hemorrhagic/necrotic nodule). Substantial overlap was present regarding the baseline sonographic features of benign vs. malignant lesions. With contrast-enhanced sonography, all renal cell carcinomas were characterized by large tortuous arteries, sometimes enhancing slightly earlier than vessels in the surrounding normal kidney. During the late corticomedullary phase, renal cell carcinomas had intense homo- or heterogeneous, iso- or slightly hypoechoic enhancement, which decreased progressively. Compared with renal cell carcinoma, histiocytic sarcoma and lymphoma had smaller and less obvious arteries, and an earlier loss of enhancement during the late phase. All hemangiosarcoma metastases appeared as nonenhancing nodules during the early arterial and late corticomedullary phases of enhancement, and additional lesions were detected. Histiocytic sarcoma and benign lesions had increased conspicuity with baseline sonography. The descriptions provided herein will be valuable as more work is done to establish the role of contrast-enhanced sonography in the assessment of renal lesions.

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