M Macari1, M A Bosniak. 1. Department of Radiology, New York University Medical Center, Tisch Hospital, NY 10016, USA. michael.macari@med.nyu.edu
Abstract
PURPOSE: To determine whether delayed computed tomography (CT) can help confirm vascularity in a neoplasm and differentiate it from a high-density cyst when a well-demarcated homogeneous high-attenuating (> 30-HU) renal mass is incidentally discovered during contrast material-enhanced CT. MATERIALS AND METHODS: In 25 patients, 26 well-demarcated, homogeneous high-attenuating renal masses (mean diameter, 2.5 cm; range, 1-4 cm) detected at initial postcontrast CT were further evaluated with delayed CT (mean, 38 minutes; range, 15-240 minutes) performed with identical parameters. On both the initial postcontrast and delayed CT scans, region-of-interest measurements were obtained in renal masses and in the gallbladder or low-density renal cysts as controls. Correlation with surgical or additional imaging findings was used to determine proof of diagnosis. RESULTS: Nine of the masses demonstrated no change in attenuation between initial postcontrast and delayed CT, indicating that they represented avascular lesions consistent with high-density cysts. These cases were confirmed with prior or follow-up imaging studies that demonstrated stability. Seventeen masses (nine surgically proved neoplasms and eight neoplasms that demonstrated interval growth at follow-up or previous CT) demonstrated decreased attenuation at delayed CT compared with initial postcontrast CT, which indicates vascularity. CONCLUSION: Delayed CT of incidentally discovered well-demarcated homogeneous high-attenuating (> 30-HU) renal masses detected at postcontrast CT enables differentiation of high-density cysts from renal neoplasms by demonstrating deenhancement as a proof of vascularity and, hence, neoplasm.
PURPOSE: To determine whether delayed computed tomography (CT) can help confirm vascularity in a neoplasm and differentiate it from a high-density cyst when a well-demarcated homogeneous high-attenuating (> 30-HU) renal mass is incidentally discovered during contrast material-enhanced CT. MATERIALS AND METHODS: In 25 patients, 26 well-demarcated, homogeneous high-attenuating renal masses (mean diameter, 2.5 cm; range, 1-4 cm) detected at initial postcontrast CT were further evaluated with delayed CT (mean, 38 minutes; range, 15-240 minutes) performed with identical parameters. On both the initial postcontrast and delayed CT scans, region-of-interest measurements were obtained in renal masses and in the gallbladder or low-density renal cysts as controls. Correlation with surgical or additional imaging findings was used to determine proof of diagnosis. RESULTS: Nine of the masses demonstrated no change in attenuation between initial postcontrast and delayed CT, indicating that they represented avascular lesions consistent with high-density cysts. These cases were confirmed with prior or follow-up imaging studies that demonstrated stability. Seventeen masses (nine surgically proved neoplasms and eight neoplasms that demonstrated interval growth at follow-up or previous CT) demonstrated decreased attenuation at delayed CT compared with initial postcontrast CT, which indicates vascularity. CONCLUSION: Delayed CT of incidentally discovered well-demarcated homogeneous high-attenuating (> 30-HU) renal masses detected at postcontrast CT enables differentiation of high-density cysts from renal neoplasms by demonstrating deenhancement as a proof of vascularity and, hence, neoplasm.
Authors: C L Brown; R P Hartman; O P Dzyubak; N Takahashi; A Kawashima; C H McCollough; M R Bruesewitz; A M Primak; J G Fletcher Journal: Eur Radiol Date: 2009-01-20 Impact factor: 5.315
Authors: Sabina Sevcenco; Martin Krssak; Domagoj Javor; Lothar Ponhold; Franklin E Kuehhas; Harun Fajkovic; Andrea Haitel; Sharokh F Shariat; Pascal A Baltzer Journal: World J Urol Date: 2014-03-09 Impact factor: 4.226