Clinical Application of Ultrasound in the Diagnosis and Treatment of Reninoma

doi:10.37015/AUDT.2020.200013

Abstract

Abstract:

Objectives: To investigate the clinical value of ultrasound in the diagnosis and treatment of reninoma.
Methods: We retrospectively analyzed the ultrasound findings of 9 patients with reninoma confirmed by pathology after surgical resection in our hospital between September 2012 and August 2019. All patients underwent conventional preoperative ultrasonography. Three underwent contrast-enhanced ultrasound (CEUS) and 3 with complete endogenetic tumor underwent intraoperative ultrasonography.
Results: Of the 9 patients with conventional ultrasound, 7 had renal space-occupying lesions and 2 had missed diagnosis. A hypoechoic or hyperechoic solid mass with regular morphology, clear boundary, capsule, weak echo halo around the mass, incomplete thin strip color blood flow signal around the mass were shown in 7 cases. Color Doppler displayed color flow signal of the incomplete thin strip around the mass and arterial blood supply with an internal thin branch. In 3 patients (including 2 with missing diagnosis by conventional ultrasound) who underwent preoperative contrast-enhanced ultrasound, the reninoma manifested as low enhancement, and the perfusion pattern showed as slow wash-in and slow wash-out compared with normal renal cortex. In 3 patients (including 2 cases of missed diagnosis by conventional ultrasound) with completely endogenic reninoma, intraoperative ultrasound clearly showed the tumor characteristics, and all successfully underwent laparoscopic ultrasound-guided partial nephrectomy.
Conclusions: Preoperative conventional ultrasound combined with CEUS, and clinical features, are helpful for the qualitative diagnosis of reninoma. Laparoscopic partial resection is the first-choice treatment for reninoma. Intraoperative ultrasound can provide real-time imaging, accurately evaluate the tumor status, and provide important information for surgeons.

Key words: Reninoma; Contrast-enhanced ultrasound; Intraoperative ultrasound

Qiuyang Li, MD, Ying Zhang, MD, Yong Song, MD, Aitao Guo, MD, Nan Li, BS, Yukun Luo, MD, Jie Tang, MD. Clinical Application of Ultrasound in the Diagnosis and Treatment of Reninoma. Advanced Ultrasound in Diagnosis and Therapy, 2020, 4(3): 211-216.

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