Amorphous Bosniak 1 renal cyst (CEUS)
Citation, DOI and case data
Known chronic kidney disease with multiple simple cyst. Irregular cyst noted in the left kidney on B-mode US.
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- On B-mode US the cyst in question has an amorphous shape and has discrete wall irregularity, however it is almost completely anechoic. No flow signal using microvascular flow imaging.
- No artifacts on the T0 image.
- The cyst does not show enhancement in the arterial phase, and remains signal-free throughout the portal venous and late phase. Findings altogether are in line with an amorphous but simple, Bosniak 1 renal cyst.
- Surveying the liver during the late phase shows small cysts appearing as signal voids on the CEUS image.
CEUS is an excellent method to reassuringly characterize amorphous-looking cysts detected by other imaging (noncontrast US in particular) techniques. It is also prudent to perform a survey of the liver in the late phase, since incidental but clinically significant lesions can be picked up this way.
Note: as of 2021 renal CEUS is considered an off-label use in most countries.