Additional value of microvascular flow imaging in the assessment of cystic and solid renal lesions.

Autor:	Járay Á; 1Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary., Farkas PI; 1Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary., Semjén D; 2Department of Pathology, Medical School, University of Pécs, Pécs, Hungary., Battyáni I; 1Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary., Botz B; 1Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary.; 3Molecular Pharmacology Research Team and Centre for Neuroscience, János Szentágothai Research Centre, University of Pécs, Hungary.
Jazyk:	angličtina
Zdroj:	Physiology international [Physiol Int] 2023 Feb 08; Vol. 110 (1), pp. 52-63. Date of Electronic Publication: 2023 Feb 08 (Print Publication: 2023).
DOI:	10.1556/2060.2022.00133
Abstrakt:	Background: Contrast enhanced ultrasound (CEUS) is increasingly used in the evaluation of renal lesions, however, its availability remains limited. Thus, sensitive noncontrast ultrasound evaluation of renal lesion vascularity is an unmet need. Methods: In this single-center, retrospective study we assessed microvascular flow imaging (MV-flow) compared to CEUS in the evaluation of complex renal cysts and solid lesions. Out of 92 patients 28 were evaluated with both CEUS and MV-flow. Color Doppler, CEUS, and MV-flow was performed in 13 cases, whilst MV-flow, CEUS, and contrast-enhanced MV-flow (CE-MV-flow) was done in 16 cases. The CEUS diagnosis was considered gold standard. Results: MV-flow showed a substantial agreement with the CEUS diagnosis (weighted Kappa = 0.806), excluding equivocal lesions (Bosniak 2F). MV-flow substantially outperformed color Doppler (weighted Kappa = 0.77 vs. 0.133). The agreement of CE-MV-flow and MV-flow was comparable (weighted Kappa = 0.79 vs. 0.69). Conclusion: MV-flow significantly improves evaluation of renal lesion vascularity compared to conventional techniques. However, the sensitivity is limited for equivocal lesions (e.g. Bosniak 2F cysts). Thus, MV-flow should be used as an ancillary technique, not as a substitute to CEUS. Current MV-flow presets are ill-suited for postcontrast imaging, therefore specific presets optimized for this purpose are needed to establish its potential.
Databáze:	MEDLINE
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