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Purpose Renal lesions are frequent random findings on CT, MRI, andconventional ultrasound. Since they are usually found accidentally, therespective examinations have not been performed optimally to provide aconclusive diagnosis, making additional multiphase contrast-enhancedexaminations necessary. The aim of the study is to correlate CEUS findings withthe final diagnosis and to determine whether it is a suitable method for theconclusive characterization of undetermined renal lesions.  Materials and Methods All CEUS examinations of focal renal lesionsperformed at our institute between 2007 and 2014 were retrospectively examined.437 patients with a total of 491 lesions and 543 examinations were included. 54patients had bilateral lesions. One patient had three lesions in one kidney.Histology was available in 49 cases and follow-ups in 124 cases. Thesensitivity, specificity, positive and negative predictive value as well aspositive and negative likelihood ratios were calculated.  Results There were 54 malignant and 437 benign lesions. The sensitivityand specificity were 0.981/0.954 overall, 1.000/0.956 for cysticlesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for thehistologically confirmed lesions. Bosniak classification was consistent in 289of 301 lesions (96%). Only 12 lesions (3.9%) were falselyassessed as malignant.  Conclusion CEUS is an appropriate method for the clarification ofundetermined renal lesions. The characterization of cystic lesions according toBosniak is adequately possible, especially for potentially malignant lesions(types III and IV).

Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study