ldtЛучевая диагностика и терапияDiagnostic radiology and radiotherapy2079-5343Baltic Medical Education Center10.22328/2079-5343-2020-12-1-14-23ldt-577Research ArticleЛЕКЦИИ И ОБЗОРЫLECTURES AND REVIEWSУльтразвуковое исследование с контрастированием в алгоритме диагностики солидных образований почекDiagnostic algorithm of solid kidney lesions with contrast-enhanced ultrasoundhttps://orcid.org/0000-0001-6576-1087КадырлеевР. А.KadyrleevR. A.

Кадырлеев Роман Андреевич — аспирант научного отделения диагностической и интервенционной радиологии, врач ультразвуковой диагност отделения лучевой диагностики.

197758, Санкт-Петербург, пос. Песочный, Ленинградская ул., д. 68.

SPIN-код: 7360-4884

Roman A. Kadyrleev.

St. Petersburg.

romankadyrleev@gmail.comhttps://orcid.org/0000-0002-0940-6491БуськоЕ. А.BuskoE. A.

Бусько Екатерина Александровна — кандидат медицинских наук, доцент НК и ОЦ «Лучевая диагностика и ядерная медицина», медицинский факультет СПбГУ; ведущий научный сотрудник научного отделения диагностической и интервенционной радиологии, врач ультразвуковой диагност, врач-рентгенолог отделения лучевой диагностики НМИЦ онкологии им. Н.Н. Петрова МЗ РФ.

199034, Санкт-Петербург, Университетская наб., д. 7-9; 197758, Санкт-Петербург, пос. Песочный, Ленинградская ул., д. 68.

SPIN-код: 7323-1083

Ekaterina A. Busko.

St. Petersburg.

katrn@mail.ruhttps://orcid.org/0000-0002-4245-687XКостроминаЕ. В.KostrominaE. V.

Костромина Екатерина Викторовна — кандидат медицинских наук, доцент кафедры лучевой диагностики и биомедицинской визуализации СПбГПМУ МЗ РФ; старший научный сотрудник научного отделения диагностической и интервенционной радиологии, врач ультразвуковой диагност, врач-рентгенолог отделения лучевой диагностики НМИЦ онкологии им. Н.Н. Петрова МЗ РФ.194100, Санкт-Петербург, Литовская ул., д. 2;197758, Санкт-Петербург, пос. Песочный, Ленинградская ул., д. 68.SPIN-код: 4865-8479

Ekaterina V. Kostromina.

St. Petersburg.

terik-dog@mail.ruhttps://orcid.org/0000-0003-4533-1658ШевкуновЛ. Н.ShevkunovL. N.

Шевкунов Лев Николаевич — кандидат медицинских наук, старший научный сотрудник научного отделения диагностической и интервенционной радиологии, заведующий отделением лучевой диагностики.

197758, Санкт-Петербург, пос. Песочный, Ленинградская ул., д. 68.

SPIN-код: 9559-7880

Lev N. Shevkunov.

St. Petersburg.

levka1978@mail.ruhttps://orcid.org/0000-0001-9611-0439КозубоваК. В.KozubovaK. V.

Козубова Ксения Вячеславовна — врач ультразвуковой диагност отделения лучевой диагностики.

197758, Санкт-Петербург, пос. Песочный, Ленинградская ул., д. 68.

SPIN-код: 4834-3728

Ksenia V. Kozubova.

St. Petersburg.

ksu_erkina@mail.ruhttps://orcid.org/0000-0002-4131-6293БагненкоС. С.BagnenkoS. S.

Багненко Сергей Сергеевич — доктор медицинских наук, доцент, ведущий научный сотрудник научного отделения диагностической и интервенционной радиологии НМИЦ онкологии им. Н.Н. Петрова МЗ РФ; доцент кафедры (рентгенологии и радиологии с курсом ультразвуковой диагностики), ВМедА им. С.М.Кирова МЗ РФ; профессор кафедры современных методов диагностики и радиолучевой терапии СПбГПМУ МЗ РФ.

197758, Санкт-Петербург, пос. Песочный, Ленинградская ул., д. 68; 194044, Санкт-Петербург, ул. Академика Лебедева, д. 6; 194100, Санкт-Петербург, Литовская ул., д. 2.

SPIN-код: 4389-9374

Sergey S. Bagnenko.

St. Petersburg.

bagnenko_ss@mail.ruНациональный медицинский исследовательский центр онкологии имени Н.Н. ПетроваРоссияN.N. Petrov National Medical Research Center of Oncology, St. Petersburg, RussiaRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Петрова; Санкт-Петербургский государственный университетРоссияN.N. Petrov National Medical Research Center of Oncology; St. Petersburg State UniversityRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Петрова; Санкт-Петербургский государственный педиатрический медицинский университетРоссияN.N. Petrov National Medical Research Center of Oncology; St. Petersburg State Pediatric Medical UniversityRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Петрова; Санкт-Петербургский государственный университет; Военно-медицинская академия имени С.М. КироваРоссияN.N. Petrov National Medical Research Center of Oncology; St. Petersburg State Pediatric Medical University; Kirov Military Medical AcademyRussian Federation2021190320211211423Copyright © Кадырлеев Р.А., Бусько Е.А., Костромина Е.В., Шевкунов Л.Н., Козубова К.В., Багненко С.С., 20212021Кадырлеев Р.А., Бусько Е.А., Костромина Е.В., Шевкунов Л.Н., Козубова К.В., Багненко С.С.Kadyrleev R.A., Busko E.A., Kostromina E.V., Shevkunov L.N., Kozubova K.V., Bagnenko S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://radiag.bmoc-spb.ru/jour/article/view/577

Солидные новообразования почек чаще всего имеют первичное происхождение, реже могут быть вторичными (метастазы, лимфома). Злокачественные поражения почек на сегодняшний день имеют тенденцию к существенному ежегодному росту. Несмотря на множество доступных методов обследования, нередко возникают трудности в дифференциальной диагностике ряда образований почек. В статье рассматриваются современные возможности лучевых методов в выявлении и оценке образований почек, их роль в определении тактики ведения пациентов. Кроме того, представлены подходы к оценке характеристик этих образований с помощью компьютерной томографии (КТ) и позитронно-эмиссионной томографии (ПЭТ), магнитно-резонансной томографии (МРТ), а также ультразвуковое исследование (УЗИ) с контрастированием. Анализ современной литературы показал, что существующие на сегодняшний день лучевые методы диагностики не дают абсолютную возможность в проведении дифференциальной диагностики редких опухолей почки. Эхоконтрастирование по данным различных авторов демонстрирует высокие показатели эффективности, но не превышает эти показатели в сравнении с КТ и МРТ. Контрастно-усиленное УЗИ — потенциально безопасный метод и может быть использован с целью дообследования сомнительных образований почек.

Most often any kidney lesions are primary renal, but sometimes they can be secondary (metastases, lymphoma). Every year renal cell carcinoma tends to a significant increase in the incidence. Today there are many available methods of examination, however difficulties often remain in the differential diagnosis of kidney lesions. The article discusses about the modern possibilities of methods in the identification and assessment of kidney lesions, their role in determining the tactics of patient management and key approaches in imaging characterization of these masses using CT and PET, MRI and CEUS. The analysis of the modern literature has shown that the currently existing radiation diagnostic methods do not provide an absolute opportunity for differential diagnosis of rare kidney tumors. CEUS, according to various authors, demonstrates high efficiency indicators, but does not exceed these indicators in comparison with CT and MRI. Contrast-enhanced ultrasound is a potentially safe method and can be used as a method for additional examination to characterize indeterminate renal lesions.

почечно-клеточный рак (ПКР)контрастно-усиленное ультразвуковое исследование (КУУЗИ)компьютерная томография (КТ)магнитно-резонансная томография (МРТ)позитронно-эмиссионная томография (ПЭТ)renal cell carcinoma (RCC)contrast enhanced ultrasound (CEUS)computed tomography (CECT)magnetic resonance imaging (MRI)positron emission tomography (PET)ReferencesKazmierski B., Deurdulian C., Tchelepi H. Applications of contrast-enhanced ultrasound in the kidney // Abdominal Radiology. 2018. Vol. 43, No. 4. P. 880-898. doi: 10.1007/s00261-017-1307-0.Kazmierski B., Deurdulian C., Tchelepi H. Applications of contrast-enhanced ultrasound in the kidney // Abdominal Radiology. 2018. Vol. 43, No. 4. P. 880-898. doi: 10.1007/s00261-017-1307-0.Чиссов В.И, Давыдов М.И. Онкология. Национальное руководство. Краткое издание. М.: ГЭОТАР-Медиа, 2017. 576 с.Chissov V.I., Davydov M.I. Oncology. National leadership. Short edition. Moscow: Publishing house GEOTAR-Media, 2017, 576 p. (In Russ.).Каприн А.Д., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2018 году (заболеваемость и смертность). М.: МНИОИ им. П.А.Герцена, 2019. 250 c.Kaprin A.D., Starinskiy V.V., Petrova G.V. Malignant neoplasms in Russia in 2018 (morbidity and mortality). Moscow: Publishing house ROC named after P.A.Herzen, 2019. 250 p. (In Russ.).Ferlay J., Colombet M., Soerjomataram I., Dyba T., Randi G., Bettio M., Bray F. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018 // European journal of cancer. 2018. Vol. 103. P. 356-387. doi: 10.1016/j.ejca.2018.07.005.Ferlay J., Colombet M., Soerjomataram I., Dyba T., Randi G., Bettio M., Bray F. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018 // European journal of cancer. 2018. Vol. 103. P. 356-387. doi: 10.1016/j.ejca.2018.07.005.Носов А.К., Лушина П.А. Анализ заболеваемости и смертности от рака почки в России и Санкт-Петербурге // Сибирский онкологический журнал. 2017. № 16 (5). С. 95-103. doi: 10.21294/1814-4861-2017-16-5-95103.Nosov A.K., Lushina P.A. Analysis of morbidity and mortality from kidney cancer in Russia and St. Petersburg. Siberian Journal of oncology. 2017. Vol. 16, No. 5, рр. 95-103 (In Russ.).Petejova N., Martinek A. Renal cell carcinoma: Review of etiology, pathophysiology and risk factors // Biomedical papers of the faculty of medicine of palacky university, Olomouc, Czech Republic. 2016. Vol. 160, No. 2. Р 183194. doi: 10.5507/bp.2015.050.Petejova N., Martinek A. Renal cell carcinoma: Review of etiology, pathophysiology and risk factors // Biomedical papers of the faculty of medicine of palacky university, Olomouc, Czech Republic. 2016. Vol. 160, No. 2. Р 183194. doi: 10.5507/bp.2015.050.Quaia E., Bertolotto M., Cioffi V., Rossi A., Baratella E., Pizzolato R., Cova M.A. Comparison of contrast-enhanced sonography with unenhanced sonography and contrast-enhanced CT in the diagnosis of malignancy in complex cystic renal masses // American Journal of Roentgenology. 2008. Vol. 191. P. 1239-1249. doi: 10.2214/ajr.07.3546.Quaia E., Bertolotto M., Cioffi V., Rossi A., Baratella E., Pizzolato R., Cova M.A. Comparison of contrast-enhanced sonography with unenhanced sonography and contrast-enhanced CT in the diagnosis of malignancy in complex cystic renal masses // American Journal of Roentgenology. 2008. Vol. 191. P. 1239-1249. doi: 10.2214/ajr.07.3546.Chang E.H. An Introduction to Contrast-Enhanced Ultrasound for Nephrologists // Nephron. 2017. Vol. 138, No. 3. P. 176-185. doi: 10.1159/000484635.Chang E.H. An Introduction to Contrast-Enhanced Ultrasound for Nephrologists // Nephron. 2017. Vol. 138, No. 3. P. 176-185. doi: 10.1159/000484635.Серегин А.В., Борзецовская В.В. Дифференциальная диагностика жидкостных образований почек // Онкоурология. 2012. № 8 (1). С. 102-108.Seregin A.V., Borzetsovskaya V.V. The differentiative diagnosis of renal cysts. Cancer Urology, 2012, Vol. 8, No. 1, рр. 102-108 (In Russ.).Ascenti G., Mazziotti S., Zimbaro G., Settineri N., Magno C., Melloni D., Caruso R., Scribano E. Complex cystic renal masses: characterization with contrast-enhanced US // Radiology. 2007. Vol. 243, No. 1. P. 158-165. doi: 10.1148/radiol.2431051924.Ascenti G., Mazziotti S., Zimbaro G., Settineri N., Magno C., Melloni D., Caruso R., Scribano E. Complex cystic renal masses: characterization with contrast-enhanced US // Radiology. 2007. Vol. 243, No. 1. P. 158-165. doi: 10.1148/radiol.2431051924.Quaia E. Microbubble ultrasound contrast agents: an update // European Radiology. Vol. 17, No. 8. P. 1995-2008. doi: 10.1007/s00330-007-0623-0.Quaia E. Microbubble ultrasound contrast agents: an update // European Radiology. Vol. 17, No. 8. P. 1995-2008. doi: 10.1007/s00330-007-0623-0.Siracusano S., Bertolotto M., Ciciliato S., Valentino M., Liguori G., Visalli F. The current role of contrast-enhanced ultrasound (CEUS) imaging in the evaluation of renal pathology // World Journal of Urology. Vol. 29, No. 5. P. 633638. doi: 10.1007/s00345-011-0699-7.Siracusano S., Bertolotto M., Ciciliato S., Valentino M., Liguori G., Visalli F. The current role of contrast-enhanced ultrasound (CEUS) imaging in the evaluation of renal pathology // World Journal of Urology. Vol. 29, No. 5. P. 633638. doi: 10.1007/s00345-011-0699-7.Sidhu P., Cantisani V., Dietrich C., Gilja O., Saftoiu A., Bartels E. The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version) // Ultraschall in Med. 2018. Vol 39. P. e2-e44. doi: 10.1055/a-0586-1107.Sidhu P., Cantisani V., Dietrich C., Gilja O., Saftoiu A., Bartels E. The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version) // Ultraschall in Med. 2018. Vol 39. P. e2-e44. doi: 10.1055/a-0586-1107.Regine G., Atzori M., Fabbri R. Contrast-Enhanced Ultrasound of the Urinary Tract. Milan, Heidelberg, New York, Dordrecht, London: Springer, 2013. 75 p. doi: 10.1007/978-88-470-5432-5.Regine G., Atzori M., Fabbri R. Contrast-Enhanced Ultrasound of the Urinary Tract. Milan, Heidelberg, New York, Dordrecht, London: Springer, 2013. 75 p. doi: 10.1007/978-88-470-5432-5.Gulati M., King K.G., Gill I.S., Pham V., Grant E., Duddalwar V.A. Contrast-enhanced ultrasound (CEUS) of cystic and solid renal lesions: a review // Abdominal Imaging. 2015. Vol. 40, No. 6. P. 1982-1996. doi: 10.1007/s00261-015-0348-5.Gulati M., King K.G., Gill I.S., Pham V., Grant E., Duddalwar V.A. Contrast-enhanced ultrasound (CEUS) of cystic and solid renal lesions: a review // Abdominal Imaging. 2015. Vol. 40, No. 6. P. 1982-1996. doi: 10.1007/s00261-015-0348-5.Clevert D-A., Minaifar N., Weckbach S. Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system // Clinical Hemorheology Microcirculation. 2008. Vol. 39, No. 1-4. P. 171-178.Clevert D-A., Minaifar N., Weckbach S. Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system // Clinical Hemorheology Microcirculation. 2008. Vol. 39, No. 1-4. P. 171-178.Bellini D., Panvini N., Laghi A., Marin D., Patel N. Systematic Review and Meta-Analysis Investigating the Diagnostic Yield of Dual-Energy CT for Renal Mass Assessment // American Journal of Roentgenology. 2019. Vol. 5. P. 1-10. doi: 10.2214/AJR.18.20625.Bellini D., Panvini N., Laghi A., Marin D., Patel N. Systematic Review and Meta-Analysis Investigating the Diagnostic Yield of Dual-Energy CT for Renal Mass Assessment // American Journal of Roentgenology. 2019. Vol. 5. P. 1-10. doi: 10.2214/AJR.18.20625.Wood C.G., Stromberg L.J., Harmath C.B. CT and MR imaging for evaluation of cystic renal lesions and diseases // Radiographics. 2015. Vol. 35, No. 1. P. 125-141. doi: 10.1148/rg.351130016.Wood C.G., Stromberg L.J., Harmath C.B. CT and MR imaging for evaluation of cystic renal lesions and diseases // Radiographics. 2015. Vol. 35, No. 1. P. 125-141. doi: 10.1148/rg.351130016.Krishna S., Murray C.A., McInnes M.D., Chatelain R., Siddaiah M., Al-Dandan O., Schieda, N. CT imaging of solid renal masses: pitfalls and solutions // Clinical Radiology. 2017. Vol 72, No. 9. P. 708-721. doi: 10.1016/j.crad.2017.05.003.Krishna S., Murray C.A., McInnes M.D., Chatelain R., Siddaiah M., Al-Dandan O., Schieda, N. CT imaging of solid renal masses: pitfalls and solutions // Clinical Radiology. 2017. Vol 72, No. 9. P. 708-721. doi: 10.1016/j.crad.2017.05.003.O'Connor S.D., Pickhardt P.J., Kim D.H., Oliva M.R., Silverman S.G. Incidental finding of renal masses at unenhanced CT: Prevalence and analysis of features for guiding management // American Journal of Roentgenology. 2011. Vol. 197, No. 1. P. 139-145. doi: 10.2214/AJR.10.5920.O'Connor S.D., Pickhardt P.J., Kim D.H., Oliva M.R., Silverman S.G. Incidental finding of renal masses at unenhanced CT: Prevalence and analysis of features for guiding management // American Journal of Roentgenology. 2011. Vol. 197, No. 1. P. 139-145. doi: 10.2214/AJR.10.5920.Ramamurthy N.K., Moosavi B., McInnes M-D.F., Flood T.A., Schieda N. Multiparametric MRI of solid renal masses: pearls and pitfalls // Clinical Radiology. 2015. Vol. 70, No. 3. P. 304-316. doi: 10.1016/j.crad.2014.10.006.Ramamurthy N.K., Moosavi B., McInnes M-D.F., Flood T.A., Schieda N. Multiparametric MRI of solid renal masses: pearls and pitfalls // Clinical Radiology. 2015. Vol. 70, No. 3. P. 304-316. doi: 10.1016/j.crad.2014.10.006.Zhou J.Y., Wang Y.C., Zeng C.H., Ju S.H. Renal functional MRI and its application // Journal Magnetic Resonance Imaging. 2018. Vol. 48, No. 4. P. 863-881. doi: 10.1002/jmri.26180.Zhou J.Y., Wang Y.C., Zeng C.H., Ju S.H. Renal functional MRI and its application // Journal Magnetic Resonance Imaging. 2018. Vol. 48, No. 4. P. 863-881. doi: 10.1002/jmri.26180.Rubenthaler J., Paprottka K., Marcon J., Hameister E., Hoffmann K., Joiko N., Clevert D.A. Comparison of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear solid renal lesions // Clinical Hemorheology Microcirculation. 2016. Vol. 64. P. 757763. doi: 10.3233/ch-168034.Rubenthaler J., Paprottka K., Marcon J., Hameister E., Hoffmann K., Joiko N., Clevert D.A. Comparison of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear solid renal lesions // Clinical Hemorheology Microcirculation. 2016. Vol. 64. P. 757763. doi: 10.3233/ch-168034.Nazarian S., Hansford R., Rahsepar A.A., Weltin V., McVeigh D., Ipek E.G., Kwan A., Berger R.D., Calkins H., Lardo A.C., Kraut M.A., Kamel I.R., Zimmerman S.L., Halperin H.R. Safety of magnetic resonance imaging in patients with cardiac devices // New England Journal Medicine. 2017. Vol. 377, No. 26. P. 2555-2564. doi: 10.1056/NEJMoa1604267.Nazarian S., Hansford R., Rahsepar A.A., Weltin V., McVeigh D., Ipek E.G., Kwan A., Berger R.D., Calkins H., Lardo A.C., Kraut M.A., Kamel I.R., Zimmerman S.L., Halperin H.R. Safety of magnetic resonance imaging in patients with cardiac devices // New England Journal Medicine. 2017. Vol. 377, No. 26. P. 2555-2564. doi: 10.1056/NEJMoa1604267.Liu Y. The Place of FDG PET/CT in Renal Cell Carcinoma: Value and Limitations // Frontiers in Oncology. 2016. Vol. 6. P. 201. doi: 10.3389/fonc.2016.00201.Liu Y. The Place of FDG PET/CT in Renal Cell Carcinoma: Value and Limitations // Frontiers in Oncology. 2016. Vol. 6. P. 201. doi: 10.3389/fonc.2016.00201.Ljungberg B., Bensalah K., Canfield S., Dabestani S., Hofmann F., Hora M., Kuczyk M.A., Lam T., Marconi L., Merseburger A.S., Mulders P., Powles T., Staehler M., Volpe A., Bex A. EAU guidelines on renal cell carcinoma: 2014 update // European Urology. 2015. Vol. 67, No. 5. P. 913-924. doi: 10.1016/j.eururo.2015.01.005.Ljungberg B., Bensalah K., Canfield S., Dabestani S., Hofmann F., Hora M., Kuczyk M.A., Lam T., Marconi L., Merseburger A.S., Mulders P., Powles T., Staehler M., Volpe A., Bex A. EAU guidelines on renal cell carcinoma: 2014 update // European Urology. 2015. Vol. 67, No. 5. P. 913-924. doi: 10.1016/j.eururo.2015.01.005.Koo K.C., Kim W.T., Ham W.S., Lee J.S., Ju H.J., Choi Y.D. Trends of presentation and clinical outcome of treated renal angiomyolipoma // Yonsei Medicine Journal. 2010. Vol. 51, No. 5. P. 728-734. doi: 10.3349/ymj.2010.51.5.728.Koo K.C., Kim W.T., Ham W.S., Lee J.S., Ju H.J., Choi Y.D. Trends of presentation and clinical outcome of treated renal angiomyolipoma // Yonsei Medicine Journal. 2010. Vol. 51, No. 5. P. 728-734. doi: 10.3349/ymj.2010.51.5.728.Jinzaki M., Silverman S.G., Akita H., Nagashima Y., Mikami S., Oya M. Renal angiomyolipoma: A radiological classification and update on recent developments in diagnosis and management // Abdominal Imaging. 2014. Vol. 39, No. 3. P. 588-604. doi: 10.1007/s00261-014-0083-3.Jinzaki M., Silverman S.G., Akita H., Nagashima Y., Mikami S., Oya M. Renal angiomyolipoma: A radiological classification and update on recent developments in diagnosis and management // Abdominal Imaging. 2014. Vol. 39, No. 3. P. 588-604. doi: 10.1007/s00261-014-0083-3.Bhatnagar A., Rowe S.P., Gorin M.A., Pomper M.G., Fishman E.K., Allaf M.E. Computed tomography appearance of renal hybrid oncocytic/chromo-phobe tumors // Journal of Computer Assisted Tomography. 2016. Vol. 40, No. 4. P. 513-516. doi: 10.1097/RCT.0000000000000409.Bhatnagar A., Rowe S.P., Gorin M.A., Pomper M.G., Fishman E.K., Allaf M.E. Computed tomography appearance of renal hybrid oncocytic/chromo-phobe tumors // Journal of Computer Assisted Tomography. 2016. Vol. 40, No. 4. P. 513-516. doi: 10.1097/RCT.0000000000000409.Al Harbi F., Tabatabaeefar L., Jewett M.A., Finelli A., O'Malley M., Atri M. Enhancement threshold of small (< 4 cm) solid renal masses on CT // American Journal of Roentgenology. 2016. Vol. 206. P. 554-558. doi: 10.2214/AJR.15.14806.Al Harbi F., Tabatabaeefar L., Jewett M.A., Finelli A., O'Malley M., Atri M. Enhancement threshold of small (< 4 cm) solid renal masses on CT // American Journal of Roentgenology. 2016. Vol. 206. P. 554-558. doi: 10.2214/AJR.15.14806.Zhang J., Lefkowitz R.A., Ishill N.M., Wang L., Moskowitz C.S., Russo P., Eisenberg H., Hricak H. Solid renal cortical tumors: Differentiation with CT // Radiology. 2007. Vol. 244, No. 2. P. 494-504. doi: 10.1148/radiol.2442060927.Zhang J., Lefkowitz R.A., Ishill N.M., Wang L., Moskowitz C.S., Russo P., Eisenberg H., Hricak H. Solid renal cortical tumors: Differentiation with CT // Radiology. 2007. Vol. 244, No. 2. P. 494-504. doi: 10.1148/radiol.2442060927.Kim J.H., Sun H.Y., Hwang J., Hong S.S., Cho Y.J., Doo S.W., Yang W.J., Song Y.S. Diagnostic accuracy of contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging of small renal masses in real practice: Sensitivity and specificity according to subjective radiologic interpretation // World Journal Surgery Oncology. 2016. Vol. 14, No. 1. P. 260. doi: 10.1186/s12957-016-1017-z.Kim J.H., Sun H.Y., Hwang J., Hong S.S., Cho Y.J., Doo S.W., Yang W.J., Song Y.S. Diagnostic accuracy of contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging of small renal masses in real practice: Sensitivity and specificity according to subjective radiologic interpretation // World Journal Surgery Oncology. 2016. Vol. 14, No. 1. P. 260. doi: 10.1186/s12957-016-1017-z.Thompson R.H., Kurta J.M., Kaag M., Tickoo S.K., Kundu S., Katz D., Nogueira L., Reuter V.E., Russo P. Tumor size is associated with malignant potential in renal cell carcinoma cases // The Journal of Urology. 2009. Vol. 181, No. 5. P. 2033-2036. doi: 10.1016/j.juro.2009.01.027.Thompson R.H., Kurta J.M., Kaag M., Tickoo S.K., Kundu S., Katz D., Nogueira L., Reuter V.E., Russo P. Tumor size is associated with malignant potential in renal cell carcinoma cases // The Journal of Urology. 2009. Vol. 181, No. 5. P. 2033-2036. doi: 10.1016/j.juro.2009.01.027.Leone A.R., Diorio G.J., Spiess P.E., Gilbert S.M. Contemporary issues surrounding small renal masses: evaluation, diagnostic biopsy, nephron sparing, and novel treatment modalities // Oncology. 2016. Vol. 30. P. 507-14.Leone A.R., Diorio G.J., Spiess P.E., Gilbert S.M. Contemporary issues surrounding small renal masses: evaluation, diagnostic biopsy, nephron sparing, and novel treatment modalities // Oncology. 2016. Vol. 30. P. 507-14.Vendrami C.L., Villavicencio C.P., DeJulio T.J., Chatterjee A., Casalino D.D., Horowitz J.M., Oberlin D.T., Yang G.Y., Niko-Laidis P., Miller F.H. Differentiation of solid renal tumors with multiparametric MR imaging // Radiographics: A Review Publication of the Radiological Society of North America. 2017. Vol. 37, No. 7. P. 2026-2042. doi: 10.1148/rg.2017170039.Vendrami C.L., Villavicencio C.P., DeJulio T.J., Chatterjee A., Casalino D.D., Horowitz J.M., Oberlin D.T., Yang G.Y., Niko-Laidis P., Miller F.H. Differentiation of solid renal tumors with multiparametric MR imaging // Radiographics: A Review Publication of the Radiological Society of North America. 2017. Vol. 37, No. 7. P. 2026-2042. doi: 10.1148/rg.2017170039.Sun M.R-M., Ngo L., Genega E.M., Atkins M.B., Finn M.E., Rofsky N.M., Pedrosa I. Renal cell carcinoma: Dynamic contrast-enhanced MR imaging for differentiation of tumor subtypes-correlation with pathologic findings // Radiology. 2009. Vol. 250, No. 3. P. 793-802. doi: 10.1148/radiol.2503080995.Sun M.R-M., Ngo L., Genega E.M., Atkins M.B., Finn M.E., Rofsky N.M., Pedrosa I. Renal cell carcinoma: Dynamic contrast-enhanced MR imaging for differentiation of tumor subtypes-correlation with pathologic findings // Radiology. 2009. Vol. 250, No. 3. P. 793-802. doi: 10.1148/radiol.2503080995.Woo S., Suh C.H., Cho J.Y., Kim S.Y., Kim S.H. Diagnostic performance of CT for diagnosis of fat-poor angiomyolipoma in patients with renal masses: a systematic review and meta-analysis // American Journal of Roentgenology. 2017. Vol. 209, No. 5. P. 297-307. doi: 10.2214/AJR.17.18184.Woo S., Suh C.H., Cho J.Y., Kim S.Y., Kim S.H. Diagnostic performance of CT for diagnosis of fat-poor angiomyolipoma in patients with renal masses: a systematic review and meta-analysis // American Journal of Roentgenology. 2017. Vol. 209, No. 5. P. 297-307. doi: 10.2214/AJR.17.18184.Park B.K. Renal Angiomyolipoma: Radiologic classification and imaging features according to the amount of fat // American Journal of Roentgenology. 2017. Vol. 209, No. 4. P. 826-835. doi: 10.2214/AJR.17.17973.Park B.K. Renal Angiomyolipoma: Radiologic classification and imaging features according to the amount of fat // American Journal of Roentgenology. 2017. Vol. 209, No. 4. P. 826-835. doi: 10.2214/AJR.17.17973.Sasiwimonphan K., Takahashi N., Leibovich B.C., Carter R.E., Atwell T.D., Kawashima A. Small (< 4cm) renal mass: Differentiation of angiomyolipoma without visible fat from renal cell carcinoma utilizing MR imaging // Radiology. 2012. Vol. 263, No. 1. P. 160-168. doi: 10.1148/radiol.2016164024.Sasiwimonphan K., Takahashi N., Leibovich B.C., Carter R.E., Atwell T.D., Kawashima A. Small (< 4cm) renal mass: Differentiation of angiomyolipoma without visible fat from renal cell carcinoma utilizing MR imaging // Radiology. 2012. Vol. 263, No. 1. P. 160-168. doi: 10.1148/radiol.2016164024.Jeong C.J., Park B.K., Park J.J., Kim C.K. Unenhanced CT and MRI parameters that can be used to reliably predict fat-invisible angiomyolipoma // American Journal of Roentgenology. 2016. Vol. 206, No. 2. P. 340-347. doi: 10.2214/AJR.15.15086.Jeong C.J., Park B.K., Park J.J., Kim C.K. Unenhanced CT and MRI parameters that can be used to reliably predict fat-invisible angiomyolipoma // American Journal of Roentgenology. 2016. Vol. 206, No. 2. P. 340-347. doi: 10.2214/AJR.15.15086.Lim R.S., Flood T.A., McInnes M-D.F., Lavallee L.T., Schieda N. Renal angiomyolipoma without visible fat: Can we make the diagnosis using CT and MRI? // European Radiology. 2018. Vol. 28, No. 2. P. 542-553. doi: 10.1007/s00330-017-4988-4.Lim R.S., Flood T.A., McInnes M-D.F., Lavallee L.T., Schieda N. Renal angiomyolipoma without visible fat: Can we make the diagnosis using CT and MRI? // European Radiology. 2018. Vol. 28, No. 2. P. 542-553. doi: 10.1007/s00330-017-4988-4.Patel H.D., Druskin S.C., Rowe S.P., Pierorazio P.M., Gorin M.A., Allaf M.E. Surgical histopathology for suspected oncocytoma on renal mass biopsy: a systematic review and meta-analysis // BJU International. Vol. 119, No. 5. P. 661-666. doi: 10.1111/bju.13763.Patel H.D., Druskin S.C., Rowe S.P., Pierorazio P.M., Gorin M.A., Allaf M.E. Surgical histopathology for suspected oncocytoma on renal mass biopsy: a systematic review and meta-analysis // BJU International. Vol. 119, No. 5. P. 661-666. doi: 10.1111/bju.13763.Aycock R.D., Westafer L.M., Boxen J.L., Majlesi N., Schoenfeld E.M., Bannuru R.R. Acute kidney injury after computed tomography: A meta-analy-sis // Annals of Emergency Medicine. 2018. Vol. 71, No. 1. P. 44-53. doi: 10.1016/j.annemergmed.2017.06.041.Aycock R.D., Westafer L.M., Boxen J.L., Majlesi N., Schoenfeld E.M., Bannuru R.R. Acute kidney injury after computed tomography: A meta-analy-sis // Annals of Emergency Medicine. 2018. Vol. 71, No. 1. P. 44-53. doi: 10.1016/j.annemergmed.2017.06.041.Galia M., Albano D., Bruno A., Agrusa A., Romano G., Di Buono G., Agnello F., Salvaggio G., La Grutta L., Midiri M., Lagalla R. Imaging features of solid renal masses // The British Journal of Radiology. 2017. Vol. 90, No. 1077. P. 20170077. doi: 10.1259/bjr.20170077.Galia M., Albano D., Bruno A., Agrusa A., Romano G., Di Buono G., Agnello F., Salvaggio G., La Grutta L., Midiri M., Lagalla R. Imaging features of solid renal masses // The British Journal of Radiology. 2017. Vol. 90, No. 1077. P. 20170077. doi: 10.1259/bjr.20170077.Schieda N., McInnes M.D., Cao L. Diagnostic accuracy of segmental enhancement inversion for diagnosis of renal oncocytoma at biphasic contrast enhanced CT: systematic review // European Radiology. 2014. Vol. 24, No. 6. P. 1421-1429. doi: 10.1007/s00330-014-3147-4.Schieda N., McInnes M.D., Cao L. Diagnostic accuracy of segmental enhancement inversion for diagnosis of renal oncocytoma at biphasic contrast enhanced CT: systematic review // European Radiology. 2014. Vol. 24, No. 6. P. 1421-1429. doi: 10.1007/s00330-014-3147-4.Rosenkrantz A.B., Hindman N., Fitzgerald E.F., Niver B.E., Melamed J., Babb J.S. MRI features of renal oncocytoma and chromophobe renal cell carcinoma // American Journal of Roentgenology. 2010. Vol. 195, No. 6. P. 421-427. doi: 10.2214/AJR.10.4718.Rosenkrantz A.B., Hindman N., Fitzgerald E.F., Niver B.E., Melamed J., Babb J.S. MRI features of renal oncocytoma and chromophobe renal cell carcinoma // American Journal of Roentgenology. 2010. Vol. 195, No. 6. P. 421-427. doi: 10.2214/AJR.10.4718.Hotker A.M., Mazaheri Y., Wibmer A., Zheng J.T., Moskowitz C.S., Tickoo S.K., Russo P., Hricak H., Akin O. Use of DWI in the differentiation of renal cortical tumors // American Journal of Roentgenology. 2016. Vol. 206, No. 1. P. 100-105. doi: 10.2214/AJR.14.13923.Hotker A.M., Mazaheri Y., Wibmer A., Zheng J.T., Moskowitz C.S., Tickoo S.K., Russo P., Hricak H., Akin O. Use of DWI in the differentiation of renal cortical tumors // American Journal of Roentgenology. 2016. Vol. 206, No. 1. P. 100-105. doi: 10.2214/AJR.14.13923.Sasaguri K., Takahashi N. CT and MR imaging for solid renal mass characterization // European Journal of Radiology. 2018. Vol. 99. P. 40-54. doi: 10.1016/j.ejrad.2017.12.008.Sasaguri K., Takahashi N. CT and MR imaging for solid renal mass characterization // European Journal of Radiology. 2018. Vol. 99. P. 40-54. doi: 10.1016/j.ejrad.2017.12.008.Делорм С., Дебю Ю., Йендерка К-В. Руководство по ультразвуковой диагностике. М.: МЕДпресс-информ. 2016. 408 с.Delorm S., Debu Y., Enderka K.-V. Guide to ultrasound diagnostics. Moscow: Publishing house MEDpress-inform. 2016. 408 p. (In Russ.).Xu Z.F., Xu H.X., Xie X.Y., Liu G.J., Zheng Y.L., Liang J.Y., Lu M.D. Renal cell carcinoma: realtime contrast-enhanced ultrasound findings // Abdominal Imaging. 2010. Vol. 35, No. 6. P. 750-756. doi: 10.1007/s00261-009-9583-y.Xu Z.F., Xu H.X., Xie X.Y., Liu G.J., Zheng Y.L., Liang J.Y., Lu M.D. Renal cell carcinoma: realtime contrast-enhanced ultrasound findings // Abdominal Imaging. 2010. Vol. 35, No. 6. P. 750-756. doi: 10.1007/s00261-009-9583-y.Toprak U., Erdogan A., Gulbay M., Karademir M.A., Pasaoglu E., Akar O.E. Preoperative evaluation of renal anatomy and renal masses with helical CT, 3D-CT and 3D-CT angiography // Diagnostic and Interventional Radiology. 2005. Vol. 11. P. 35-40.Toprak U., Erdogan A., Gulbay M., Karademir M.A., Pasaoglu E., Akar O.E. Preoperative evaluation of renal anatomy and renal masses with helical CT, 3D-CT and 3D-CT angiography // Diagnostic and Interventional Radiology. 2005. Vol. 11. P. 35-40.Xu H.X. Contrast-enhanced ultrasound: the evolving applications // World Journal Radiology. 2009. Vol. 1, No. 1. P. 15-24. doi: 10.4329/wjr.v1.i1.15.Xu H.X. Contrast-enhanced ultrasound: the evolving applications // World Journal Radiology. 2009. Vol. 1, No. 1. P. 15-24. doi: 10.4329/wjr.v1.i1.15.Tenant S.C., Gutteridge C.M. The clinical use of contrast-enhanced ultrasound in the kidney // Ultrasound. 2016. Vol. 24, No. 2. P. 94-103. doi: 10.1177/1742271X15627185.Tenant S.C., Gutteridge C.M. The clinical use of contrast-enhanced ultrasound in the kidney // Ultrasound. 2016. Vol. 24, No. 2. P. 94-103. doi: 10.1177/1742271X15627185.Wang C., Yu C., Yang F., Yang G. Diagnostic accuracy of contrast-enhanced ultrasound for renal cell carcinoma: a meta-analysis // Tumour Biology. 2014. Vol. 35, No. 7. P. 6343-6350. doi: 10.1007/s13277-014-1815-2.Wang C., Yu C., Yang F., Yang G. Diagnostic accuracy of contrast-enhanced ultrasound for renal cell carcinoma: a meta-analysis // Tumour Biology. 2014. Vol. 35, No. 7. P. 6343-6350. doi: 10.1007/s13277-014-1815-2.Siracusano S., Quaia E., Bertolotto M., Ciciliato S., Tiberio A., Belgrano E. The application of ultrasound contrast agents in the characterization of renatumors // World Journal Urology. 2004. Vol. 22. P. 316-322. doi: 10.1007/s00345-004-0410-3.Siracusano S., Quaia E., Bertolotto M., Ciciliato S., Tiberio A., Belgrano E. The application of ultrasound contrast agents in the characterization of renatumors // World Journal Urology. 2004. Vol. 22. P. 316-322. doi: 10.1007/s00345-004-0410-3.Jiang J., Chen Y., Zhou Y., Zhang H. Clear cell renal cell carcinoma: contrast-enhanced ultrasound features relation to tumor size // European Journal Radiology. 2010. Vol. 73. P. 162-167. doi: 10.1016/j.ejrad.2008.09.030.Jiang J., Chen Y., Zhou Y., Zhang H. Clear cell renal cell carcinoma: contrast-enhanced ultrasound features relation to tumor size // European Journal Radiology. 2010. Vol. 73. P. 162-167. doi: 10.1016/j.ejrad.2008.09.030.Tamai H., Takiguchi Y., Oka M. Shingaki N., Enomoto S., Shiraki T., Ichinose M. Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors // Journal Ultrasound Medicine. 2005. Vol. 24. P. 1635-1640. doi: 10.7863/jum.2005.24.12.1635.Tamai H., Takiguchi Y., Oka M. Shingaki N., Enomoto S., Shiraki T., Ichinose M. Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors // Journal Ultrasound Medicine. 2005. Vol. 24. P. 1635-1640. doi: 10.7863/jum.2005.24.12.1635.Gerst S., Hamm L.E., Li D., Gonen M., Tickoo S., Sohn M. J., Russo P. (2011) Evaluation of renal masses with contrast-enhanced ultrasound: initial experience // American Journal of Roentgenology. 2011. Vol. 197. No. 4. P. 897-906. doi:10.2214/ajr.10.6330.Gerst S., Hamm L.E., Li D., Gonen M., Tickoo S., Sohn M. J., Russo P. (2011) Evaluation of renal masses with contrast-enhanced ultrasound: initial experience // American Journal of Roentgenology. 2011. Vol. 197. No. 4. P. 897-906. doi:10.2214/ajr.10.6330.Roy C., Gengler L., Sauer B., Lang H. Role of contrast enhanced US in the evaluation of renal tumors // Journal de Radiology. 2008. Vol. 89. P. 17351744. doi: 10.1016/s0221-0363(08)74478-0.Roy C., Gengler L., Sauer B., Lang H. Role of contrast enhanced US in the evaluation of renal tumors // Journal de Radiology. 2008. Vol. 89. P. 17351744. doi: 10.1016/s0221-0363(08)74478-0.Kazmierski B., Deurdulian C., Tchelepi H., Grant E. Applications of contrast-enhanced ultrasound in the kidney // Abdominal Radiology (NY). 2018. Vol. 43, No. 4. P. 880-898. doi: 10.1007/s00261-017-1307-0.Kazmierski B., Deurdulian C., Tchelepi H., Grant E. Applications of contrast-enhanced ultrasound in the kidney // Abdominal Radiology (NY). 2018. Vol. 43, No. 4. P. 880-898. doi: 10.1007/s00261-017-1307-0.Park B.K., Kim B., Kim S.H. Ko K., Lee H. M., Cho H. Y. Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US // European Journal of Radiology. 2007. Vol. 61. P. 310-314. doi: 10.1016/j.ejrad.2006.10.004.Park B.K., Kim B., Kim S.H. Ko K., Lee H. M., Cho H. Y. Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US // European Journal of Radiology. 2007. Vol. 61. P. 310-314. doi: 10.1016/j.ejrad.2006.10.004.Regine G., Atzori M., Danza F.M. Malformazioni del reneedelle vie urinary // Imaging dell'apparato urogenitale. 2010. P. 13-24.Regine G., Atzori M., Danza F.M. Malformazioni del reneedelle vie urinary // Imaging dell'apparato urogenitale. 2010. P. 13-24.Zhang F., Li R., Li G. Jin L., Shi Q., Du L. Value of Contrast-Enhanced Ultrasound in the Diagnosis of Renal Cancer and in Comparison With Contrast-Enhanced Computed Tomography: A Meta-analysis // Journal of Ultrasound in Medicine. 2019. Vol. 38, No. 4. P. 903-914. doi: 10.1002/jum.14769.2018.Zhang F., Li R., Li G. Jin L., Shi Q., Du L. Value of Contrast-Enhanced Ultrasound in the Diagnosis of Renal Cancer and in Comparison With Contrast-Enhanced Computed Tomography: A Meta-analysis // Journal of Ultrasound in Medicine. 2019. Vol. 38, No. 4. P. 903-914. doi: 10.1002/jum.14769.2018.Bhatt S., MacLennan G., Dogra V. Renal pseudotumors // American Journal of Roentgenology. 2007. Vol. 188. P. 1380-1387. doi: 10.2214/ajr.06.0920.Bhatt S., MacLennan G., Dogra V. Renal pseudotumors // American Journal of Roentgenology. 2007. Vol. 188. P. 1380-1387. doi: 10.2214/ajr.06.0920.Mazziotti S., Zimbaro F., Pandolfo A. Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors // Abdominal Imaging. 2010. Vol. 35. P. 241-245. doi: 10.1007/s00261-008-9499-y.Mazziotti S., Zimbaro F., Pandolfo A. Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors // Abdominal Imaging. 2010. Vol. 35. P. 241-245. doi: 10.1007/s00261-008-9499-y.Wilson S.R., Burns P.N. (2010) Microbubble-enhanced US in body imaging: what role? // Radiology. 2010. Vol. 257. P. 24-39. doi: 10.1148/radiol.10091210.Wilson S.R., Burns P.N. (2010) Microbubble-enhanced US in body imaging: what role? // Radiology. 2010. Vol. 257. P. 24-39. doi: 10.1148/radiol.10091210.Prakash A., Tan G.J., Wansaicheong G.K. Contrast enhanced ultrasound of kidneys. Pictorial essay // Medicine Ultrasound. 2011. Vol. 13. P. 150-156.Prakash A., Tan G.J., Wansaicheong G.K. Contrast enhanced ultrasound of kidneys. Pictorial essay // Medicine Ultrasound. 2011. Vol. 13. P. 150-156.

The authors declare that there are no conflicts of interest present.