1.Diagnostic performance of contrast-enhanced ultrasound in the evaluation of renal masses in patients with renal impairment
Clement Yong ; Yi-Ming Teo ; Jeevesh Kapur
The Medical Journal of Malaysia 2016;71(4):193-198
Objective: To evaluate the performance of contrastenhanced
ultrasound (CEUS) in the risk stratification of
indeterminate renal lesions picked up incidentally on
abdominal imaging, in patients with renal impairment.
Methods: A retrospective study was performed of nonconsecutive
patients who underwent CEUS at our tertiary
care centre for indeterminate renal lesions between March
2010 and September 2014. A total of 63 patients with 74
nodules were assessed with CEUS and stratified into either
benign (Bosniak I, II, IIF) or suspicious for malignancy
(Bosniak III, IV or hypervascular solid lesions). Diagnostic
accuracy was determined by comparing these findings to
subsequent histological diagnoses, temporal change after at
least 20 months follow-up or after a diagnostic computer
tomography / magnetic resonance imaging study.
Results: CEUS correctly identified 49/52 (94.2%) of benign
lesions and 21/22 (95.5%) of malignant lesions, resulting in a
sensitivity of 95.5% (95% CI 77.2-99.9%), specificity of 94.2%
(95% CI 84.1-98.8%), positive predictive value (PPV) 87.5%
(95% CI 67.6-97.3) and negative predictive value (NPV) 98.0%
(95% CI 89.4-100%).
Conclusion: CEUS has high diagnostic performance in
predicting the benignity of a renal lesion in patients with
renal impairment, showing sensitivity and NPV approaching
100%.
Carcinoma, Renal Cell
3.Peritoneal lymphomatosis mimicking peritoneal carcinomatosis: important imaging clues for correct diagnosis.
David Soon Yiew SIA ; Jeevesh KAPUR ; Yee Liang THIAN
Singapore medical journal 2013;54(4):e93-6
Peritoneal lymphomatosis, a rare presentation of lymphoma, can mimic peritoneal carcinomatosis. Computed tomography findings in both conditions include omental caking, as well as peritoneal enhancement, thickening and nodularity. We report three cases of peritoneal lymphomatosis and give an analysis of the salient imaging features that aided in the accurate diagnosis of the condition in each case. Two of the three cases demonstrated elevated serum cancer antigen 125 levels, a marker commonly associated with ovarian carcinoma. It is thus critical to distinguish peritoneal lymphomatosis from carcinomatosis, as the prognosis and management are dramatically different.
Adult
;
Aged
;
Aged, 80 and over
;
CA-125 Antigen
;
blood
;
Carcinoma
;
diagnosis
;
diagnostic imaging
;
Diagnosis, Differential
;
Female
;
Humans
;
Lymphoma
;
diagnosis
;
diagnostic imaging
;
Male
;
Peritoneal Neoplasms
;
diagnosis
;
diagnostic imaging
;
Peritoneum
;
diagnostic imaging
;
Tomography, X-Ray Computed