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MR Imaging of the Kidneys After Laparoscopic Cryoablation

Erick M. Remer1, Eric J. Weinberg1, Aytekin Oto1,2, Charles M. O' Malley1 and Inderbir S. Gill3

1 Division of Radiology, A21, The Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195.
2 Present address: Department of Radiology, Hacettepe University Hospital, Sihhiye, Ankara, Turkey.
3 Department of Urology, Section of Minimally Invasive Surgery, The Cleveland Clinic Foundation, Cleveland, OH 44195.



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  		Fig. 1A. —69-year-old man who underwent left renal cryoablation for renal cell carcinoma. Axial unenhanced T1-weighted breath-hold fast low-angle shot MR image (TR/TE, 142/4.4; flip angle, 80°) obtained 1 day after cryoablation reveals cryolesion (solid arrow) isointense to renal parenchyma. Ovoid material adjacent to kidney is oxidized cellulose (Surgicel; Johnson & Johnson Medical, Arlington, TX) (open arrow).

 


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  		Fig. 1B. —69-year-old man who underwent left renal cryoablation for renal cell carcinoma. Axial T2-weighted turbo spin-echo MR image (3100/99) shows partial hypointense rim (arrowhead) between cryolesion and normal renal parenchyma. Note heterogeneous signal intensity (solid arrow) in cryolesion. Low-signal-intensity perinephric material (open arrow) is Surgicel.

 


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  		Fig. 1C. —69-year-old man who underwent left renal cryoablation for renal cell carcinoma. Axial T1-weighted breath-hold gadopentetate dimeglumine—enhanced MR image (142/4.4; flip angle, 80°) shows no enhancement of cryolesion.

 


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  		Fig. 1D. —69-year-old man who underwent left renal cryoablation for renal cell carcinoma. Axial T2-weighted turbo spin-echo MR image (3100/99) shows complete hypointense rim (arrowheads) between cryolesion and normal renal parenchyma. Note heterogeneous signal intensity in cryolesion (arrow).

 


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  		Fig. 2A. —64-year-old man approximately 3 months after cryoablation for right renal cell carcinoma. Axial unenhanced T1-weighted breath-hold fast low-angle shot MR image (TR/TE, 142/4.4; flip angle, 80°) shows cryolesion (arrow) isointense to renal parenchyma.

 


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  		Fig. 2B. —64-year-old man approximately 3 months after cryoablation for right renal cell carcinoma. Fat-suppressed axial T1-weighted breath-hold gadopentetate dimeglumine—enhanced MR image shows thin rim of enhancement around cryolesion (arrowheads). Rim was poorly distinguished on non—fat-suppressed sequence.

 


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  		Fig. 3A. —63-year-old man who underwent right renal cryoablation for suspicious lesion. T1-weighted breath-hold fast low-angle shot gadopentetate dimeglumine—enhanced MR images (TR/TE, 142/4.4; flip angle, 80°) show progressive decrease in cryolesion (arrows) size at 1 day (A), 1 month (B), and 3 months (C).

 


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  		Fig. 3B. —63-year-old man who underwent right renal cryoablation for suspicious lesion. T1-weighted breath-hold fast low-angle shot gadopentetate dimeglumine—enhanced MR images (TR/TE, 142/4.4; flip angle, 80°) show progressive decrease in cryolesion (arrows) size at 1 day (A), 1 month (B), and 3 months (C).

 


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  		Fig. 3C. —63-year-old man who underwent right renal cryoablation for suspicious lesion. T1-weighted breath-hold fast low-angle shot gadopentetate dimeglumine—enhanced MR images (TR/TE, 142/4.4; flip angle, 80°) show progressive decrease in cryolesion (arrows) size at 1 day (A), 1 month (B), and 3 months (C).

 


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  		Fig. 3D. —63-year-old man who underwent right renal cryoablation for suspicious lesion. Fat-suppressed MR image obtained 12 months after cryoablation shows parenchymal defect at cryoablation site.

 

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