Surgical margin follow-up after nephron-sparing surgery: the possible role of CEUS
In: Journal of Ultrasound, Jg. 23 (2019-11-18), S. 515-520
Online
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Zugriff:
PURPOSE: To evaluate the possible role of CEUS in the management of patients who underwent nephron-sparing surgery (NSS) and presented questionable findings on the surgical margins at the CECT follow-up exam. METHODS: In our retro-prospective study, we included 952 patients with small renal masses (SRMs) treated with NSS between 2012 and 2015 and followed with CECT for at least 3 years at Careggi University Hospital. Twenty-two of them presented solid masses on the site of surgery with questionable enhancement at CECT and were further studied with CEUS. This examination was followed by a quantitative analysis of the enhancement pattern. RESULTS: Out of the 22 masses, 18 were considered possible granulomas, presenting slow wash-in and low enhancement peaks compared to the surrounding parenchyma and persistent delayed wash-out at CEUS. Four lesions presented a suspicious malignant enhancement pattern, with rapid wash-in, high peak and rapid wash-out. In accordance with instructions from the urologist, the first group of 18 patients was strictly monitored, revealing that the mass dimensions and enhancement pattern were stable for at least 3 years of follow-up, while the other 4 patients underwent a second intervention and their masses were confirmed as tumor recurrence at the histopathological evaluation. CONCLUSIONS: CEUS can play a key role in the surgical margin follow-up after NSS when a suspicious enhancing mass is detected by CECT, giving an accurate depiction of the enhancement pattern and thus helping the clinician in the management of the patient.
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Surgical margin follow-up after nephron-sparing surgery: the possible role of CEUS
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Autor/in / Beteiligte Person: | Bertelli, Elena ; Agostini, Simone ; Serni, Sergio ; Minervini, Andrea ; Palombella, Alberto ; Savi, Elena ; Caramella, Davide ; Pili, Alessandro ; Mercatelli, Laura ; Miele, Vittorio ; Verna, Silvia |
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Zeitschrift: | Journal of Ultrasound, Jg. 23 (2019-11-18), S. 515-520 |
Veröffentlichung: | Springer Science and Business Media LLC, 2019 |
Medientyp: | unknown |
ISSN: | 1876-7931 (print) |
DOI: | 10.1007/s40477-019-00413-1 |
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