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Radiologic evaluation of small renal masses (I): pretreatment management.

Marhuenda A, Martín MI, Deltoro C, Santos J, Rubio Briones J - Adv Urol (2009)

Bottom Line: Is this a task for a urologist or a radiologist?It is obvious that in the increasing clinical scenario where this decision has to be made, both specialists ought to work together.Special emphasis has been placed on aspects regarding the bidirectional information between radiologists and urologists needed to achieve the best radiological approach to an SRM.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Radiología, Instituto Valenciano de Oncología, C/Profesor Beltrán Báguena 8, 46009 Valencia, Spain. amarflu@gmail.com

ABSTRACT
When characterizing a small renal mass (SRM), the main question to be answered is whether the mass represents a surgical or nonsurgical lesion or, in some cases, if followup studies are a reasonable option. Is this a task for a urologist or a radiologist? It is obvious that in the increasing clinical scenario where this decision has to be made, both specialists ought to work together. This paper will focus on the principles, indications, and limitations of ultrasound, CT, and MRI to characterize an SRM in 2008 with a detailed review of relevant literature. Special emphasis has been placed on aspects regarding the bidirectional information between radiologists and urologists needed to achieve the best radiological approach to an SRM.

No MeSH data available.


Related in: MedlinePlus

(a) Cor haste T2,(b) out of phase axial T1, (c) axial precontrast T1 with fat suppression, (d) earlypostcontrast axial T1 with fat saturation, and (e) axial postcontrast T1 withfat suppression.Small renal lesion on the lateral aspect of the upper pole of the right kidneyshows a solid mass hypointenseon T2 that does not present a loss of signal out of phase sequence and only asmall enhancement on postcontrast sequences, consistent with a papillary renal carcinoma.
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fig15: (a) Cor haste T2,(b) out of phase axial T1, (c) axial precontrast T1 with fat suppression, (d) earlypostcontrast axial T1 with fat saturation, and (e) axial postcontrast T1 withfat suppression.Small renal lesion on the lateral aspect of the upper pole of the right kidneyshows a solid mass hypointenseon T2 that does not present a loss of signal out of phase sequence and only asmall enhancement on postcontrast sequences, consistent with a papillary renal carcinoma.

Mentions: Hypervascular RCC can be easily differentiatedon dynamic contrast-enhanced MR. Hypovascular RCC, AML, and complicated cystsenhanced significantly less than cortical and medullary tissue did (see Figure 15). Furthermore, papillary RCC is typically hypovascular and shows mildcontrast enhancement, whereas AML with minimal fat is generally hypervascular and shows marked enhancement, but occasionally thedegree of enhancement varies, making this differentiation difficult [42]. Also hypovascular RCC from thefirst minute after gadolinium injection showed significantly greaterenhancement than complicated cyst [69].


Radiologic evaluation of small renal masses (I): pretreatment management.

Marhuenda A, Martín MI, Deltoro C, Santos J, Rubio Briones J - Adv Urol (2009)

(a) Cor haste T2,(b) out of phase axial T1, (c) axial precontrast T1 with fat suppression, (d) earlypostcontrast axial T1 with fat saturation, and (e) axial postcontrast T1 withfat suppression.Small renal lesion on the lateral aspect of the upper pole of the right kidneyshows a solid mass hypointenseon T2 that does not present a loss of signal out of phase sequence and only asmall enhancement on postcontrast sequences, consistent with a papillary renal carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2662406&req=5

fig15: (a) Cor haste T2,(b) out of phase axial T1, (c) axial precontrast T1 with fat suppression, (d) earlypostcontrast axial T1 with fat saturation, and (e) axial postcontrast T1 withfat suppression.Small renal lesion on the lateral aspect of the upper pole of the right kidneyshows a solid mass hypointenseon T2 that does not present a loss of signal out of phase sequence and only asmall enhancement on postcontrast sequences, consistent with a papillary renal carcinoma.
Mentions: Hypervascular RCC can be easily differentiatedon dynamic contrast-enhanced MR. Hypovascular RCC, AML, and complicated cystsenhanced significantly less than cortical and medullary tissue did (see Figure 15). Furthermore, papillary RCC is typically hypovascular and shows mildcontrast enhancement, whereas AML with minimal fat is generally hypervascular and shows marked enhancement, but occasionally thedegree of enhancement varies, making this differentiation difficult [42]. Also hypovascular RCC from thefirst minute after gadolinium injection showed significantly greaterenhancement than complicated cyst [69].

Bottom Line: Is this a task for a urologist or a radiologist?It is obvious that in the increasing clinical scenario where this decision has to be made, both specialists ought to work together.Special emphasis has been placed on aspects regarding the bidirectional information between radiologists and urologists needed to achieve the best radiological approach to an SRM.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Radiología, Instituto Valenciano de Oncología, C/Profesor Beltrán Báguena 8, 46009 Valencia, Spain. amarflu@gmail.com

ABSTRACT
When characterizing a small renal mass (SRM), the main question to be answered is whether the mass represents a surgical or nonsurgical lesion or, in some cases, if followup studies are a reasonable option. Is this a task for a urologist or a radiologist? It is obvious that in the increasing clinical scenario where this decision has to be made, both specialists ought to work together. This paper will focus on the principles, indications, and limitations of ultrasound, CT, and MRI to characterize an SRM in 2008 with a detailed review of relevant literature. Special emphasis has been placed on aspects regarding the bidirectional information between radiologists and urologists needed to achieve the best radiological approach to an SRM.

No MeSH data available.


Related in: MedlinePlus