COMPARATIVE STUDY OF RENAL MASSES BY ULTRASONOGRAPHY AND COMPUTED TOMOGRAPHY
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BACKGROUNDThe term renal mass includes a large number of expansile entities, which are aggregates of non-functional renal parenchyma.Renal masses can be neoplastic, non-neoplastic or normal variants [pseudotumours].The aim of this study is to study and evaluate the nature of renal masses by ultrasound and computed tomography. MATERIALS AND METHODSThis retrospective descriptive study was carried out in the Department of Radiology, Patna Medical College and Hospital, duri ng October 2015 -October 2016 in one year duration.Fifty patients irrespective of age and sex, suspicious of malignant renal masses were included in this study.Ultrasound was done by Toshiba Nemio XG USG machine with different types of probes-curvilinear with 3.5 -5 MHz and linear probe with 7 -10 MHz frequency and also by Colour Doppler study whenever needed.Toshiba 128slice Computed Tomography Scan was used for scanning of all patients, plain and contrast both studies were performed and collected data was analysed. RESULTSFifty cases of renal masses comprising of polycystic kidney disease, [1] parapelvic cyst, [2] renal cell carcinoma, [3] Wilms' tumour [4] and squamous cell carcinoma [5] were clinically studied and evaluated radiologically by ultrasonography and CT.Ultrasound remains the modality of choice for initial screening in cases of adult polycystic kidney disease. CONCLUSIONIt can be concluded from our study that ultrasound and contrast CT scan is an investigation of choice for pre-operative staging of malignant renal masses due to its ability in demonstrating perinephric extension, invasion of renal fascia, evaluation of retroperitoneum and detection of distant metastases.Keywords:
Renal mass
In a series of 32 operated renal carcinoma patients, the ability of ultrasonography (US), computed tomography (CT) and arteriography to demonstrate the local spreading of renal carcinoma was investigated. Operation showed that 23 of the renal carcinomas were local. Nine carcinomas had spread locally. CT was the most sensitive indicator of local spreading (particularly perirenal extension). CT examinations, however, also gave most of the false positive findings. The number of false negative findings was highest in the US group.
Renal carcinoma
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Objective: To evaluate anatomic factors and radiologist's experience in the detection of solid renal masses on ultrasonography.Methods: We searched for solid renal masses diagnosed on cross-sectional imaging from 2007 to 2017 that also had previous ultrasonography from the past 6 months.The following features were evaluated: nodule size, laterality, location and growth pattern, patient body mass index and radiologist's experience in ultrasound.In surgically resected cases, pathologic reports were evaluated.Unpaired t test and χ 2 test were used to evaluate differences among subgroups, using R-statistics.Statistical significance was set at p<0.05.Results: The initial search of renal nodules on cross-sectional imaging resulted in 428 lesions and 266 lesions were excluded.Final cohort included 162 lesions and, of those, 108 (67%) were correctly detected on ultrasonography (Group 1) and 54 (33%) were missed (Group 2).Comparison of Groups 1 and 2 were as follows, respectively: body mass index (27.7 versus 27.1; p=0.496), size (2.58cm versus 1.74cm; p=0.003), laterality (54% versus 59% right sided; p=0.832), location (27% versus 22% upper pole; p=0.869), growth pattern (25% versus 28% endophytic; p=0.131) and radiologist's experience (p=0.300).From surgically resected cases, histology available for Group 1 was clear cell (n=11), papillary (n=15), chromophobe (n=2) renal cell carcinoma, oncocytoma (n=1), and, for Group 2, clear cell (n=7), papillary (n=5) renal cell carcinoma, oncocytoma (n=2), angiomyolipoma, chromophobe renal cell carcinoma, and interstitial pyelonephritis (n=1, each).Conclusion: Size was the only significant parameter related to renal nodule detection on ultrasound.
Nodule (geology)
Renal mass
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Liver Cancer
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A seven-year-old boy with cystic fibrosis (CS) who presented with abdominal pain is reported. Ultrasonographic and computed tomographic studies of the upper abdomen revealed unusual liver findings. An ultrasound scan showed a liver that was exceedingly heterogeneous and a mixed echo pattern with dominant hyperechogenicity. Computed tomography showed large, multiple hypodense cyst-like lesions in the liver. Using the ultrasound scan as a guide, a needle biopsy was performed. The pathological findings were in accord with the findings obtained from ultrasonography and computed tomography, and were consistent with pathological findings seen in CS cases.
Abdominal computed tomography
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Percutaneous biopsy
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Ultrasonography, computed tomography and 99mTc liver scanning are all useful in diagnosis of patients with the Budd-Chiari syndrome. In a study to determine their comparative value characteristic findings were recorded in all nine patients at ultrasonography and in seven patients at computed tomography. In contrast 99mTc liver scan showed a characteristic pattern in only one of eight patients. In our experience intrahepatic venous abnormalities were seen better at ultrasonography than at computed tomography. In addition, abnormality in the direction of blood flow could be detected by pulsed Doppler examination. Ultrasonography is relatively inexpensive, readily accessible, does not require administration of radiation or contrast agents and therefore should be the primary non-invasive investigation of patients with Budd-Chiari syndrome, or those at risk of developing it.
Budd–Chiari syndrome
Abnormality
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This study aimed to estimate the performance of single-phase-enhanced computed tomography and ultrasonography examinations in the preoperative evaluation of solid abdominal tumors and their relationship with relevant adjacent structures in children.This retrospective study included 50 pediatric patients with malignant solid abdominal tumors treated with surgical resection between 2009-2017. Preoperative computed tomography and ultrasonography were compared to operative findings (gold standard) in the diagnosis of invasion or encasement of adjacent structures. Accuracy, sensitivity, specificity, and positive and negative predictive values were evaluated.Renal (20.4%) and neuroblastic (19.4%) tumors were the most common. Complete surgical resection with negative margins was achieved in 44 (88%) patients. The comparison between single-phase-enhanced computed tomography and ultrasonography findings showed the following results: sensitivity = 90.3% vs 86.6%, specificity = 86.8% vs 94.6%, negative predictive value = 95.3% vs 94.4%, positive predictive value = 75.3% vs 86.9%, and accuracy = 87.9% vs 92.2%. The correlation (kappa index) between computed tomography and ultrasonography examinations was 0.72 (p < 0.001). In 14% (7/50) of the patients, the invasion of adjacent structures was diagnosed by ultrasonography but not by computed tomography (1 patient had 2 invaded structures).Ultrasonography can be considered a complementary method to single-phase-enhanced computed tomography in the preoperative evaluation of children with an abdominal tumor. The present study showed that ultrasonography and single-phase-enhanced computed tomography each possess a high accuracy in the preoperative planning of resection of solid abdominal tumors in children. Thus, it seems that the combination of both imaging methods would be enough for the evaluation of most abdominal tumors in the pediatric population.
Abdominal ultrasonography
Gold standard (test)
Multidetector computed tomography
Abdominal computed tomography
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Multidetector computed tomography
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The detection and evaluation of renal masses have changed significantly with improved radiographic techniques such as ultrasonography, CT, and magnetic resonance imaging (MRI). Historically, due to their retroperitoneal location, renal masses often remained clinically silent until large enough to cause local signs and symptoms, a frequent harbinger of advanced disease [1]. Currently, in an era of ubiquitous imaging with ultrasonography or CT for various complaints, incidental discovery by cross-sectional imaging with ultrasonography or CT has become the most common presentation of a renal mass [2–4]. Significantly, increased detection has led to diagnosis of renal cell carcinomas (RCCs) that are smaller and of a lower stage, with fewer patients presenting with metastatic disease [2,5–7]. Ultimately, serendipitous discovery of smaller lesions should correspond to improved cure rates and increased patient survival.KeywordsRenal Cell CarcinomaInferior Vena CavaPartial NephrectomyTransitional Cell CarcinomaRenal MassThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Renal mass
Presentation (obstetrics)
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