Staging of renal carcinoma using magnetic resonance imaging at 1.5 Tesla

Fast breath-hold T2-weighted MRI of the kidney by means of half-Fourier single-shot turbo spin echo: comparison with high resolution turbo spin echo sequence

PURPOSE

The value of the fast half-Fourier single-shot turbo spin echo (HASTE) sequence in T2-weighted MRI of the kidney was evaluated as a substitute for the conventional turbo spin echo (TSE) sequence.

METHOD

Forty-five patients with suspected abnormalities of the kidney underwent MRI with a 1.5 T system. Breath-hold HASTE and respiratory-triggered TSE sequences were performed. Qualitative and quantitative analyses were performed for comparison of these sequences.

RESULTS

The signal-to-noise ratio (SNR) with HASTE was higher than that with TSE. The lesion-to-kidney contrast-to-noise ratio for solid masses with HASTE was almost equal to that with TSE. For cystic masses, the CNR with HASTE was significantly higher than that with TSE (p < 0.05). Respiratory and chemical shift artifacts were significantly smaller on HASTE than on TSE (p < 0.01). However, the blurring artifact was higher on HASTE than on TSE (p = 0.01).

CONCLUSION

The HASTE sequence generates high contrast images and is free of motion and chemical shift artifacts, with much better time efficacy. The sequence provides comparable diagnostic information to TSE sequences.

[Tumor thrombosis of the left renal vein and inferior vena cava secondary to renal cell carcinoma. Findings with ultrasonography, Echo-Doppler, and computerized tomography]

Renal cell carcinoma represents a 2.5-3% of all neoplastic processes, usually seen un patients older than 50 years. 60-75% are resectable at diagnosis, representing local or metastatic advanced disease the rest of them. This tumor tends to spread intravascularly, leading to tumoral thrombosis within the inferior caval vein (ICV) and renal vein 4-10% and 21-35% of cases, respectively. As the only effective treatment is surgical resection, preoperative determining of the thrombus extension is crucial. Thus, an accurate radiological study including ultrasound, doppler sonography, computed tomography and/or Magnetic Resonance, is key for these patients. We present a 49 year-old patient with renal cell carcinoma and associated tumoral thrombosis in inferior caval vein and left renal vein; we provide the most significant figures, explaining its most characteristic radiological findings.

The role of imaging in staging renal adenocarcinoma

Numerous surgical options are available to physicians treating patients with renal adenocarcinoma. In the current clinical setting, imaging plays a key role in determining which options are selected. Newer imaging techniques such as helical CT with CT angiography, MRI, and ultrasound (US) have improved staging capabilities in this patient population. However, to approach staging accuracies recently reported, attention must be paid to proper imaging parameters. This article describes the strengths, limitations, and proper techniques used for staging renal adenocarcinoma with CT, MRI, and US.

Case report: neovascularity of inferior vena cava tumour thrombus from renal cell carcinoma--CT and MRI appearance

Renal cell carcinoma is a highly vascular tumour that frequently invades vascular structures. Neovascularization within an intravascular mass has occasionally been demonstrated on CT and angiography. We report a case with MR evidence of neovascularity in the inferior vena cava secondary to a renal cell carcinoma.

Intraoperative ultrasound in the evaluation of tumor involvement of the inferior vena cava

The successful excision of genitourinary malignancies extending to the inferior vena cava relies heavily on accurate preoperative imaging. For the majority of these patients magnetic resonance imaging, inferior venacavography, abdominal ultrasound or abdominal computerized tomography will reliably predict the extent of inferior vena caval involvement by tumor. However, occasionally the results of these studies will conflict or be called into question intraoperatively. We report on 8 patients considered to be at risk for inferior vena caval involvement by tumor and for whom intraoperative ultrasound was obtained to clarify the presence or extent of thrombus. Five patients had renal cell carcinoma and 3 had adrenal carcinoma. In all patients concern as to the extent or presence of tumor was based on either inconclusive preoperative studies or unexpected intraoperative findings. In each case intraoperative ultrasound clearly visualized the inferior vena cava and established the presence or extent of tumor invasion. In 4 patients venacavotomy was avoided as a consequence of these findings. Intraoperative ultrasound is a useful tool that can accurately assess the inferior vena cava for possible tumor invasion, especially when the presence or extent of tumor involvement is not definitively established preoperatively.

Parenchymal Neoplasm of the Kidney Today: Radiologic Characterization and Staging

The development of non-invasive imaging devices has modified the diagnostic approach to parenchymal renal lesions. This report explains the radiologic characteristics of parenchymal lesions for good characterization and shows the usefulness of various devices in the staging of neoplastic lesions.