Magnetic resonance imaging in the diagnosis and staging of renal tumor: a comparison with computed tomography

Choi, Ho Cheol; Park, Choal Hee; Lee, Sung Choon

Abstract

The purpose of this study was to compare the accuracy of MRI and CT in the diagnosis and staging or renal tumor especially renal cell carcinoma. MRI was performed with an 2. O T Specto 20000 super-conductive MR scanner using conventional T1-and T2-weiehted spin-echo pulse sequences. MRI was performed in 22 patients with renal tumor. 19 of whom were renal cell carcinoma. The remaining 3 patients were adrenocortical tumor, oncocytoma and cholesteatoma. respectively. In 19 consecutive patients with renal cell carcinoma. radical nephrectomy was performed in 13 patients and percutaneous needle biopsy was done in one patient MRI studies were reviewed and compared with CT and pathologic findings. Renal cell carcinoma had a varied MR signal with the most common appearance being a mass with an intensity intermediate between the renal cortex and the medulla on T-weighted images and hyper-intense on T2-weiehted images. MRI was similar to CT in staging renal cell carcinoma, especially. Robson stage I, II, IIIb and IV : stage I-CT 90 %. MRI 95 %, stage II-CT 71 %. MRI 79 %, stage Es-CT 57 %. MRI 64 %, stage IV-CT 79 %. MRI 86 %. But MRI clearly showed venous invasion without the use of intravenous contrast medium and was superior to CT: slaee RA. renal vein involvement-CT 64%. MRI 79 %. IVC involvement-CT 57%. MRI 86 %. MRI had the possibility of delineating the tumor in several planes, which might be an advantage in displaying renal vein and vena caval involvement. It was concluded that CT remained the method of choice in the diagnosis and staging of renal tumor as long as no substantial improvements in MRI performance had been achieved. However, MRI was recommended when CT results were equivocal, when intravenous contrast was to be avoided, as well as to aid in the staging of renal tumor.