Renal masses and ultrasound.

Among the first 111 patients with renal masses examined by ultrasound most renal cysts (98%) and carcinomas (86%) were correctly detected. Diagnostic accuracy was high when ultrasound predicted a renal cyst (97%), but renal carcinoma accounted for only 60% of the complex echo masses found. Ultrasound was used as the primary, non-invasive test for the selection of outpatients with simple renal cysts for diagnostic puncture and for the selection of those with complex renal masses for more elaborate and expensive inpatient investigation. Ultrasound is not infallible but a safe diagnostic pathway may be drawn up in which ultrasound errors are not allowed to lead to diagnostic disasters. This approach reduced the use of arteriography for renal masses by two-thirds. With care the diagnosis of the common chance finding of a renal mass can be made simpler, safer, and cheaper.