Renal lesions: controlled comparison between CT and 1.5-T MR imaging with nonenhanced and gadolinium-enhanced fat-suppressed spin-echo and breath-hold FLASH techniques.

Nonenhanced and gadolinium-enhanced fat-suppressed spin-echo and breath-hold fast low-angle shot (FLASH) magnetic resonance (MR) imaging techniques were compared with iodine contrast material-enhanced computed tomography (CT) for the detection and characterization of renal masses. MR studies included T1-weighted fat-suppressed spin-echo (T1FS) and FLASH images followed by rapid injection of gadopentetate dimeglumine and a repeated FLASH image obtained at 1 second, a T1FS image at 30 seconds, and a FLASH image at 10 minutes. Of 38 patients, 17 had renal cysts, 18 had solid tumors, two had cortical scarring, and one had a hypertrophied column of Bertin. With contrast-enhanced T1FS, contrast-enhanced FLASH, and CT images, 114, 110, and 109 lesions, respectively, were detected. With MR imaging and CT, cysts smaller than 5 mm in diameter and solid tumors as small as 1 cm in diameter were detected. With combined contrast-enhanced FLASH and T1FS images, 112 lesions were correctly characterized as cystic or solid; with nonenhanced T1FS images, 110; with nonenhanced FLASH images, 107; and with nonenhanced CT, 103.