Contrast enhanced computed tomography (CECT) today is regarded as the method of choice for detection and characterisation of kidney lesions and renal tumours but there are still some limitations, e.g. nephrotoxicity of contrast media and the obvious lack of clear discrimination between benign and malignant tumours.
Contrast enhanced ultrasound (CEUS) is a recently developed real time technique applying blood pool tracers to overcome the known limitations of conventional B-mode and Doppler techniques. It is of importance that CEUS and CECT are not equivalent as ultrasound contrast agents have different pharmacokinetics and are confined to the intravascular space, whereas contrast agents for CT are rapidly cleared from the blood pool into the extracellular space. Other inherent advantages of CEUS include the possibility to assess the contrast enhancement patterns in real time with a substantially higher temporal resolution than other imaging modalities. Furthermore, no important renal or thyroidal side effects have been observed so far.
CEUS has been introduced for diagnostic imaging in the liver, heart, pancreas, trauma and several other organs. In addition, detection and characterisation of focal liver lesions are the single most important application of CEUS in the abdomen. CEUS now equals CECT and in some instances exceeds it in accuracy. Preliminary results indicate also a potential role for CEUS in the characterisation of renal cell carcinoma (RCC) but its use for kidney evaluation has been less comprehensively studied. The aim of this presentation and review of the literature is to describe CEUS features of renal disease.