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Evaluation of Pseudoenhancement of Renal Cysts During Contrast-Enhanced CT

¹ All authors: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.

View larger version (32K): [in a new window]   Fig. 1A. —Diagrams of two renal phantoms. Two-dimensional diagram shows large cylindric phantom that houses attachable water-filled spheres suspended in contrast bath.

View larger version (33K): [in a new window]   Fig. 1B. —Diagrams of two renal phantoms. Two-dimensional diagram shows small phantom containing 1.4-mm-diameter cylinders in contrast bath. Cylinders were positioned to simulate exophytic and intraparenchymal lesions.

View larger version (21K): [in a new window]   Fig. 2. —Bar graph shows effect of beam energy (peak kilovoltage) on pseudoenhancement of 28-mm water sphere. Lower peak kilovoltage settings produced more pronounced pseudoenhancement. White = 80 kVp, lightly shaded = 100 kVp, darkly shaded = 120 kVp, black = 140 kVp.

View larger version (19K): [in a new window]   Fig. 3. —Bar graph shows effect of sphere size on pseudoenhancement at 140 kVp. Small spheres tend to pseudoenhance more than large spheres. White = 6 mm, lightly shaded = 10 mm, darkly shaded = 16 mm, black = 28 mm.

View larger version (17K): [in a new window]   Fig. 4. —Bar graph shows effect of distance from contrast bath surface on pseudoenhancement at 140 kVp in 14-mm cylinder. Attenuation increases as cylinder approaches bath surface, then decreases as cylinder is raised out of contrast bath. White = -17 mm, lightly shaded = -1 mm, darkly shaded = 6 mm, black = 17 mm.

View larger version (144K): [in a new window]   Fig. 5A. —32-year-old woman with dysmenorrhea. Unenhanced CT image (collimation, 5 mm) shows 2-cm low-density intraparenchymal lesion measuring 18 H in right kidney.

View larger version (157K): [in a new window]   Fig. 5B. —32-year-old woman with dysmenorrhea. Three contiguous nephrographic-phase CT images (collimation, 5 mm; pitch, 1.5:1) of same lesion as in A. Unenhanced attenuation was 35 H (pseudoenhancement, 17 H). Lesion was stable for more than 3 years of radiographic follow-up (not shown) and is presumed to represent simple cyst. Note circular regions of interest labeled "1" on A and C.

View larger version (165K): [in a new window]   Fig. 5C. —32-year-old woman with dysmenorrhea. Three contiguous nephrographic-phase CT images (collimation, 5 mm; pitch, 1.5:1) of same lesion as in A. Unenhanced attenuation was 35 H (pseudoenhancement, 17 H). Lesion was stable for more than 3 years of radiographic follow-up (not shown) and is presumed to represent simple cyst. Note circular regions of interest labeled "1" on A and C.

View larger version (152K): [in a new window]   Fig. 5D. —32-year-old woman with dysmenorrhea. Three contiguous nephrographic-phase CT images (collimation, 5 mm; pitch, 1.5:1) of same lesion as in A. Unenhanced attenuation was 35 H (pseudoenhancement, 17 H). Lesion was stable for more than 3 years of radiographic follow-up (not shown) and is presumed to represent simple cyst. Note circular regions of interest labeled "1" on A and C.

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