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Abstract

Background

The differential diagnosis of cystic renal masses still faces great challenges. There has been no systematically assessment to compare the value of contrast-enhanced ultrasound (CEUS) with magnetic resonance imaging (MRI) in the diagnosis of cystic renal masses.

Purpose

To perform a meta-analysis to compare the diagnostic efficacy of CEUS with that of MRI for cystic renal masses.

Material and Methods

A systematic search was performed for literature evaluating the diagnostic performance of CEUS or MRI in cystic renal masses. Quality assessment of diagnostic studies 2 (QUADAS-2) was used to evaluate the quality of each study included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the areas under the summary receiver operating characteristic (AUCs-SROC) curve for CEUS and MRI were calculated, respectively.

Results

Seventeen studies with 1142 lesions were included. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for CEUS /MRI were 0.95/0.92, 0.84/0.91, 5.62/6.74, and 0.09/0.13, respectively. The AUCs-SROC curves for the two methods were 95.66% and 94.65%. The subgroup analysis indicated that the scanning slice thickness may influence the diagnostic efficacy of MRI.

Conclusion

Both CEUS and MRI have good diagnostic performance for cystic renal masses and can provide the reference for clinicians. CEUS is more sensitive but less specific than MRI.

Keywords

Contrast-enhanced ultrasound magnetic resonance imaging cystic renal masses diagnostic performance kidney cysts

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References

Seppala

Kielar

Dabreo

et al.

Inter-rater agreement in the characterization of cystic renal lesions on contrast-enhanced MRI. Abdom Imaging 2014; 39: 1267–1273.

Elstob

Gonsalves

Patel

. Diagnostic modalities. Int J Surg 2016; 36: 504–512.

Hindman

. Cystic renal masses. Abdom Radiol 2016; 41: 1020–1034.

Hélénon

Delavaud

Dbjay

et al.

A practical approach to indeterminate and cystic renal masses. Semin Ultrasound CT MR 2017; 38: 10–27.

Whiting

Rutjes

Westwood

et al.

QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155: 529–536.

Defortescu

Cornu

Béjar

et al.

Diagnostic performance of contrast-enhanced ultrasonography and magnetic resonance imaging for the assessment of complex renal cysts: a prospective study. Int J Urol 2017; 24: 184–189.

Chen

Xue

et al.

Comparison of contrast-enhanced sonography with MRI in the diagnosis of complex cystic renal masses. J Clin Ultrasound 2015; 43: 203–209.

Mao

Zhang

. The value of contrast-enhanced ultrasonography in differential diagnosis of cystic renal carcinoma. Tianjin Med J 2016; 44: 230–233.

Yong

Teo

Jeevesh

. Diagnostic performance of contrast-enhanced ultrasound in the evaluation of renal masses in patients with renal impairment. Med J Malaysia 2016; 71: 193–198.

10.

Xue

Huang

et al.

Contrast-enhanced ultrasonography for evaluation of cystic renal mass: in comparison to contrast-enhanced CT and conventional ultrasound. Abdom Imaging 2014; 39: 1274–1283.

11.

Zhang

Wei

et al.

Contrast enhanced ultrasonography prediction of cystic renal mass in comparison to histopathology. Clin Hemorheol Microcirc 2014; 58: 429–438.

12.

Nicolau

Buñesch

Paño

et al.

Prospective evaluation of CT indeterminate renal masses using US and contrast-enhanced ultrasound. Abdom Imaging 2015; 40: 542–551.

13.

Quaia

Bertolotto

Cioffi

et al.

Comparison of contrast-enhanced sonography with unenhanced sonography and contrast-enhanced CT in the diagnosis of malignancy in complex cystic renal masses. Am J Roentgenol 2008; 191: 1239–1249.

14.

Wang

Miao

Cui

et al.

Application of contrast-enhanced ultrasound in the diagnosis of renal cystic lesion. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2008; 30: 22–26.

15.

Ascenti

Mazziotti

Settineri

et al.

Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 2007; 243: 158–165.

16.

Ferreira

Reis

Kajiwara

et al.

MRI evaluation of complex renal cysts using the Bosniak classification: a comparison to CT. Abdom Radiol (NY) 2016; 41: 2011–2019.

17.

Chen

. Analysis of diagnostic value of MRI of Bosniak classification for renal complex cystic lesions. Henan Med Res 2016; 25: 1457–1458.

18.

Hai

. CT and MRI imaging diagnosis of cystic renal cell carcinoma. Chin Comm Doc 2016; 32: 137–138.

19.

Han

. Comparison of Bosniak classification and CT and MRI manifestations of renal cystic lesions. Chin Comm Doc 2015; 31: 96–99.

20.

Chen

Liu

et al.

Application of the Bosniak classification system in the diagnosis of complex cystic renal masses by MRI. Chin Med Pharm 2012; 02: 99–100.

21.

. Application of CT and MRI for differentiating benign from malignant cystic renal space-occupying lesions. J Pract Med Imaging 2010; 11: 174–176.

22.

Liu

Zhou

Peng

et al.

Application of Bosniak renal cyst classification system in MRI diagnosis of complex cystic renal lesions. Radiol Practice 2010; 25: 1263–1267.

23.

Park

Kim

. Differentiation of Bosniak categories IIF and III cystic masses: what radiologists should know. J Comput Assist Tomogr 2010; 34: 847–854.

24.

Nicolau

Bunesch

Sebastia

. Renal complex cysts in adults: contrast-enhanced ultrasound. Abdom Imaging 2011; 36: 742–752.

25.

Gulati

King

Gill

et al.

Contrast-enhanced ultrasound (CEUS) of cystic and solid renal lesions: a review. Abdom Imaging 2015; 40: 1982–1996.

26.

Park

Kim

et al.

Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol 2007; 61: 310–314.

27.

Graumann

Osther

Karstoft

et al.

Bosniak classification system: a prospective comparison of CT, contrast-enhanced US, and MR for categorizing complex renal cystic masses. Acta Radiol 2016; 57: 1409–1417.

28.

Clevert

Minaifar

Weckbach

et al.

Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system. Clin Hemorheol Microcirc 2008; 39: 171–178.

29.

Vedanayagam

Bhattacharya

Sriprasad

. Magnetic resonance imaging and the use in small renal masses. Indian J Surg Oncol 2017; 8: 19–23.

30.

Israel

Hindman

Bosniak

. Evaluation of cystic renal masses: comparison of CT and MR imaging by using the Bosniak classification system. Radiology 2004; 231: 365–371.

31.

Rosenkrantz

Wehrli

Mussi

et al.

Complex cystic renal masses: comparison of cyst complexity and Bosniak classification between 1.5 T and 3 T MRI. Eur J Radiol 2014; 83: 503–508.

32.

Hecht

Israel

Krinsky

et al.

Renal masses: quantitative analysis of enhancement with signal intensity measurements versus qualitative analysis of enhancement with image subtraction for diagnosing malignancy at MR imaging. Radiology 2004; 232: 373–378.

33.

Heverhagen

. Noise measurement and estimation in MR imaging experiments. Radiology 2007; 245: 638–639.

34.

Chandarana

Block

Rosenkrantz

et al.

Free-breathing radial 3D fat-suppressed T1-weighted gradient echo sequence: a viable alternative for contrast-enhanced liver imaging in patients unable to suspend respiration. Invest Radiol 2011; 46: 648–653.

35.

Acar

Harman

Sen

et al.

Angiomyolipoma with epithelial cyst (AMLEC): a rare variant of fat poor angiomyolipoma mimicking malignant cystic mass on MR imaging. Diagn Interv Imaging 2015; 96: 1195–1198.

36.

Ogura

Maeda

Miyai

et al.

Effects of slice thickness and matrix size on MRI for signal detection. Nihon Hoshasen Gijutsu Gakkai Zasshi 2005; 61: 1140–1143.

37.

Rübenthaler

Paprottka

Marcon

et al.

Comparison of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear solid renal lesions. Clin Hemorheol Microcirc 2016; 64: 757–763.

38.

Tombesi

Ermili

et al.

Management of incidental renal masses: Time to consider contrast-enhanced ultrasonography. Ultrasound 2016; 24: 34–40.

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Comparison of contrast-enhanced ultrasound with MRI in the diagnosis of complex cystic renal masses: a meta-analysis

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

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References

Supplementary Material