Lidia Ciobanu

By Lidia Ciobanu, Attila Tamas Szora, Alexandru Florin Badea, Mihai Suciu and Radu Badea

Nowadays, kidney tumor diagnosis benefits from large and highly accurate imagistic methods. A new imagistic method is contrast-enhanced ultrasound (CEUS) that accurately depicts the circulatory pattern of tumors. In kidney pathology, any mass or even capsular deformation depicted by B mode ultrasound represents an indication for CEUS. The kidney is completely and uniformly vascularized. In cystic tumors, there is a lack of contrast loading. In “impure” cystic masses (Bosnian 3 and 4), CEUS reveals vascularized septa and walls. In malignant tumors, accelerated and heterogeneous loading of contrast agent is observed in arterial phase followed by early, inhomogeneous washout of the contrast agent compared to normal renal parenchyma. In the abscesses, the appearance is the early loading of the walls associated with moderate hyperemia of the normal circulatory bed. This chapter details the CEUS in kidney tumor pathology, emphasizing the accurate information for the circulatory pattern of renal masses. It requires correlations with clinical data and information provided by other imaging explorations to make a final diagnosis.

Part of the book: Evolving Trends in Kidney Cancer

By Lidia Ciobanu

Pancreatic elastography represents a challenging new procedure for inflammatory pathology or tumour masses. There are technical difficulties for accurate assessment of pancreatic stiffness due to deep localization. But the new software for both conventional and endoscopic ultrasound are promising techniques for differential diagnosis between malignant tumours and different forms of chronic pancreatitis (groove pancreatitis or autoimmune pancreatitis). Early diagnosis of chronic pancreatitis, noninvasively by transabdominal shear wave elastography, is actively studied nowadays. Elastography might offer a predictive tool for the occurrence of pancreatic fistula after pancreatoduodenectomy. This chapter introduces the recent innovation of pancreatic elastography and makes recommendations for its use.

Part of the book: Ultrasound Elastography