The value of contrast-enhanced ultrasound in differentiating benign from malignant retroperitoneal masses

Eur J Radiol. 2024 Sep:178:111596. doi: 10.1016/j.ejrad.2024.111596. Epub 2024 Jun 29.

Abstract

Objectives: To evaluate the value of contrast-enhanced ultrasound (CEUS) perfusion patterns in the differentiation of benign and malignant retroperitoneal masses (RMs).

Methods: Between 2006 and 2023, 122 consecutive patients with an RM visualizable by B-mode US were investigated additionally with CEUS. On CEUS, the extent of enhancement (classified as marked, reduced, or absent) and the homogeneity of enhancement (HE; classified as homogeneous or inhomogeneous) were evaluated. Subsequently, the malignancy rate according to CEUS perfusion patterns was determined.

Results: On CEUS, marked enhancement was significantly more frequently associated with malignancy than with benignity (p < 0.0001, Fisher's exact test). All lesions with no enhancement were benign. Regarding HE, there was no significant difference between benign and malignant lesions (p = 0.07, Fisher's exact test).

Conclusion: On CEUS, marked enhancement in an RM may be indicative of a malignant lesion. Furthermore, absent enhancement can be considered to be an indication of benignity. The use of CEUS can be helpful in the evaluation of the malignancy of retroperitoneal masses.

Keywords: CEUS; Diagnosis; Retroperitoneal masses; Ultrasound.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Enhancement / methods
  • Male
  • Middle Aged
  • Phospholipids
  • Reproducibility of Results
  • Retroperitoneal Neoplasms* / diagnostic imaging
  • Sensitivity and Specificity
  • Sulfur Hexafluoride
  • Ultrasonography* / methods
  • Young Adult

Substances

  • Contrast Media
  • Sulfur Hexafluoride
  • Phospholipids
  • contrast agent BR1