The diagnostic characteristics and strategies of conventional ultrasonography in hyperechoic small renal cell carcinoma:a single-center study
Objective To explore the characteristics and strategies of conventional ultrasonog-raphy in the diagnosis of hyperechoic small renal cell carcinoma,and improve the clinical diagnosis ac-curacy of small renal cell carcinoma.Methods A total of 52 cases of hyperechoic small renal cell car-cinoma confirmed by surgery in our hospital between August 2016 and June 2022 were retrospectively analyzed for the ultrasound characteristics and diagnosis and treatment experience,with CT examina-tions attached.Tumor length and diameter of 8-25 mm.Tumor echoes were classified as slightly hy-perechoic or hyperechoic according to the relative ratio of the tumor to the renal parenchyma.Results Among the 52 cases of small renal cell carcinoma,49 cases were clear cell carcinoma,2 cases were papillary cell carcinoma,and 1 case was multilocular cystic renal cell carcinoma.Forty-five cases were slightly hyperechoic,7 cases were hyperechoic.Twelve cases were first diagnosed as renal angiomyoli-poma by ultrasound,9 cases were recalled by ultrasound for follow-up,and 3 cases had been diag-nosed by surgery before the recall.No tumor was found in the first ultrasound diagnosis of 8 cases,while CT suggested space-occupying,which was confirmed by clinical feedback and subsequent ultra-sound review.Ten cases of CT scan showed no tumor,6 cases were recalled by ultrasound,and 4 ca-ses had been diagnosed by surgery before the recall.In the other case,no tumor was found on ultra-sound or CT,and subsequent enhancement suggested space-occupying,which was confirmed by ultra-sound review.The detection rate of ultrasound combined with CT was higher than that of first ultra-sound diagnosis,and the difference was statistically significant[98.08％(51/52)vs.82.69％(43/52),x2=7.081,P=0.008].Conclusions Hyperechoic small renal cell carcinoma is easily misdiagnosed as renal angiomyolipoma by ultrasonography.Ultrasound recall changed the course of dis-ease in some patients with small renal tumors.Ultrasound combined with CT helps to reduce the missed diagnosis rate of small renal cell carcinoma.
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