TY - JOUR
T1 - Small (≤3 cm) renal masses
T2 - Correlation of spiral CT features and pathologic findings
AU - Silverman, S. G.
AU - Lee, B. Y.
AU - Seltzer, S. E.
AU - Bloom, D. A.
AU - Corless, C. L.
AU - Adams, D. F.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1994
Y1 - 1994
N2 - OBJECTIVE. We describe our 3-year experience using spiral CT in the evaluation of small renal masses in order to determine the usefulness of this technique for classifying the lesions and to correlate specific CT features with pathologic findings. MATERIALS AND METHODS. We retrospectively analyzed spiral CT scans and results of pathologic examinations of surgically extirpated small (≤3 cm) renal masses in 35 patients. The masses included 27 renal cell carcinomas, two transitional cell carcinomas, one leiomyoma, one angiomyolipoma, and four benign cysts. Several imaging features, including attenuation, pattern of contrast enhancement, presence and type of calcification, cyst wall, and septation, were correlated with pathologic findings. RESULTS. Most renal cell carcinomas had a solid growth pattern (n = 19), had attenuation values on unenhanced scans of 20 H or greater (n = 26), and had attenuation values that increased by at least 10 H with contrast enhancement (n = 26). Only three renal cell carcinomas were mostly cystic on pathologic examination. Heterogeneous enhancement correlated with the presence of acellular regions (p = .02). Of 12 cystic masses, spiral CT showed the absence of a thick or nodular fibrous capsule in seven of nine masses (specificity, 0.78) and the absence of several (or nodular) septations in six of seven masses (specificity, 0.86) but was not as sensitive in detecting these features. CONCLUSION. Spiral CT can show many of the key imaging features of small renal masses used to distinguish between benign and malignant lesions. However, despite the theoretical benefits of volumetric CT, some lesions remain indeterminate and require surgical removal for diagnosis.
AB - OBJECTIVE. We describe our 3-year experience using spiral CT in the evaluation of small renal masses in order to determine the usefulness of this technique for classifying the lesions and to correlate specific CT features with pathologic findings. MATERIALS AND METHODS. We retrospectively analyzed spiral CT scans and results of pathologic examinations of surgically extirpated small (≤3 cm) renal masses in 35 patients. The masses included 27 renal cell carcinomas, two transitional cell carcinomas, one leiomyoma, one angiomyolipoma, and four benign cysts. Several imaging features, including attenuation, pattern of contrast enhancement, presence and type of calcification, cyst wall, and septation, were correlated with pathologic findings. RESULTS. Most renal cell carcinomas had a solid growth pattern (n = 19), had attenuation values on unenhanced scans of 20 H or greater (n = 26), and had attenuation values that increased by at least 10 H with contrast enhancement (n = 26). Only three renal cell carcinomas were mostly cystic on pathologic examination. Heterogeneous enhancement correlated with the presence of acellular regions (p = .02). Of 12 cystic masses, spiral CT showed the absence of a thick or nodular fibrous capsule in seven of nine masses (specificity, 0.78) and the absence of several (or nodular) septations in six of seven masses (specificity, 0.86) but was not as sensitive in detecting these features. CONCLUSION. Spiral CT can show many of the key imaging features of small renal masses used to distinguish between benign and malignant lesions. However, despite the theoretical benefits of volumetric CT, some lesions remain indeterminate and require surgical removal for diagnosis.
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U2 - 10.2214/ajr.163.3.8079852
DO - 10.2214/ajr.163.3.8079852
M3 - Article
C2 - 8079852
AN - SCOPUS:0028016309
SN - 0361-803X
VL - 163
SP - 597
EP - 605
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 3
ER -