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Computerized contrast angiosonography:a new diagnostic tool for the urologist?
Author(s) -
Reichelt O.,
Wunderlich H.,
Weirich T.,
Schlichter A.,
Schubert J.
Publication year - 2001
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2001.02261.x
Subject(s) - hypervascularity , medicine , hounsfield scale , second harmonic imaging microscopy , renal cell carcinoma , radiology , nuclear medicine , power doppler , perfusion , lesion , renal cortex , ultrasonography , kidney , computed tomography , pathology , physics , optics , laser , second harmonic generation
Objectives To evaluate the diagnostic potential of echo‐enhanced ultrasonography (US) for depicting the vascularization pattern of renal cell carcinoma (RCC), and calculating the first‐pass effect using harmonic imaging, against that obtained by triphasic helical computed tomography (CT). Patients and methods Sixty patients with surgically confirmed RCC underwent US using B‐mode and power Doppler methods with or without an intravenous microbubble echo‐enhancing agent. After depicting and defining the tumour extent by B‐mode US, the first‐pass effect/enhancement by the echo‐enhancing agent within the lesion, and that of a reference area of unaffected renal cortex, were recorded on‐line by calculating the mean pixel intensity. Time‐intensity curves, i.e. the rise time and gradient of both the suspected tumour and reference areas, were constructed. Results Using B‐mode US, the extent of all tumours was delineated (mean tumour size 3.8 cm, sd 0.6). After applying the microbubble agent all tumours were enhanced, whereas the perfusion was decreased (in 48%), increased (in 16%) or similar (in 36%) compared with the cortical reference area. Using the Hounsfield classification, these results correlated well with the hypo/hypervascularity shown on CT. Conclusion Ultrasonography has considerable potential in diagnosing RCC, if combined with echo‐enhancing methods, harmonic imaging and computer‐based calculation of tumour vascularization. Dynamic US studies should provide a diagnostic yield similar to that of CT.