Renal cyst - Bosniak type II (CEUS)

Case contributed by Dr Balint Botz

Presentation

Complex cyst with rim-like calcification found incidentally in the left kidney during a screening abdominal US. Referred for further evaluation.

Patient Data

Age: 30 years
Gender: Male
Ultrasound

As with any other CEUS exam, a thorough B-mode evaluation should precede the administration of iv. contrast. 

The cyst appears moderately complex with a crescent-shaped irregular, echogenic wall thickening, and no marked vascularity when examined with color Doppler imaging. 

Ultrasound

The cyst remains anechoic without enhancement after the administration of the contrast agent (SonoVue) putting it into the type II category of the Bosniak classification. Note that the enhancement pattern of the kidney is much more rapid than that of the liver therefore imaging in the arterial phase is the most critical. Continuous cine recording while fanning back and forth through the lesion ensures that even modest differences in enhancement can be detected. 

Case Discussion

Typical CEUS appearance of a benign, Bosniak type II renal cyst.

NOTE: As of 2019 renal CEUS is considered an off-label use in most countries. 

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Case information

rID: 68346
Published: 27th May 2019
Last edited: 16th Jun 2019
System: Urogenital
Inclusion in quiz mode: Included
Institution: University of Pécs

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