Contrast enhanced ultrasonography prediction of cystic renal mass in comparison to histopathology

OBJECTIVES To investigate the value of contrast-enhanced ultrasonography (CEUS) in histologic subtype prediction of cystic renal mass. METHODS Eighty-seven cystic renal masses were scanned by CEUS, and the CEUS findings and pathological results were recorded. The CEUS features of different histologic subtype cystic renal masses were analyzed and compared. RESULTS Among 87 renal cystic masses, 63 masses were malignant and 24 were benign. CEUS characteristics of benign and malignant cystic renal masses were significantly different. Different subtype cystic renal cell carcinoma had different CEUS imaging appearances. Multilocular cystic renal cell carcinomas (MCRCC) were more likely to be of Bosniak classification III. Clear cell renal cell carcinomas (CCRCC) were significantly more likely to appear as a multilocular cystic pattern combined with Bosniak classification IV. Cystic papillary renal cell carcinomas (PRCC) were more likely to appear as an unilocular cystic pattern combined with Bosniak classification IV. MCRCC combined with benign cystic masses were more likely to be classified as Bosniak classification III, which was significantly different from CCRCCs and PRCCs. CONCLUSIONS CEUS can be helpful in differentiating MCRCCs and benign cystic masses from CCRCCs and PRCCs. CEUS might be useful in histologic subtype prediction and clinical management of cystic renal mass.