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High-Resolution Multidetector CT in the Preoperative Evaluation of Patients with Renal Cell Carcinoma

¹ All authors: Department of Radiology, University of Rome "La Sapienza," V.le Regina Elena 324, 00161 Rome, Italy.

View larger version (16K): [in a new window]   Fig. 1. —Results of multidetector CT (MDCT) and surgery in assessment of presence of pseudocapsule, invasion of adjacent organs, presence of distant metastasis, involvement of lymph nodes, infiltration of renal vein or inferior vena cava (IVC), invasion of adrenal glands, and infiltration of perinephric fat. Surgery = gray bar, MDCT = white bar.

View larger version (102K): [in a new window]   Fig. 2A. —54-year-old man with two small lesions in right kidney that were initially detected on sonography (not shown) before multidetector CT (MDCT) was performed. Arterial phase coronal reformatted MDCT image shows two hypervascular capsulated lesions (arrows) in upper and lower pole of kidney.

View larger version (142K): [in a new window]   Fig. 2B. —54-year-old man with two small lesions in right kidney that were initially detected on sonography (not shown) before multidetector CT (MDCT) was performed. Arterial phase thin-slice maximum-intensity-projection (MIP) image shows two right renal arteries.

View larger version (105K): [in a new window]   Fig. 2C. —54-year-old man with two small lesions in right kidney that were initially detected on sonography (not shown) before multidetector CT (MDCT) was performed. Venous phase thin-slice MIP image shows two renal veins.

View larger version (166K): [in a new window]   Fig. 3A. —23-year-old woman with clinical history of amenorrhea and incidental renal lesion initially seen on sonography (not shown) before multidetector CT (MDCT) was performed. Transverse nephrographic phase MDCT image shows 5-cm solid lesion, well defined by pseudocapsule (arrowheads), in right kidney.

View larger version (168K): [in a new window]   Fig. 3B. —23-year-old woman with clinical history of amenorrhea and incidental renal lesion initially seen on sonography (not shown) before multidetector CT (MDCT) was performed. Pseudocapsule and absence of perinephric fat infiltration (arrow, C) are also well seen on nephrographic phase of oblique coronal reformatted MDCT image (B) and on arterial phase of oblique sagittal MDCT image (C).

View larger version (142K): [in a new window]   Fig. 3C. —23-year-old woman with clinical history of amenorrhea and incidental renal lesion initially seen on sonography (not shown) before multidetector CT (MDCT) was performed. Pseudocapsule and absence of perinephric fat infiltration (arrow, C) are also well seen on nephrographic phase of oblique coronal reformatted MDCT image (B) and on arterial phase of oblique sagittal MDCT image (C).

View larger version (173K): [in a new window]   Fig. 4A. —65-year-old woman who presented with hematuria and was previously scheduled to undergo left nephrectomy due to renal cell carcinoma. Thin-slice arterial phase maximum-intensity-projection image shows hypervascular lesion (arrow) in right kidney.

View larger version (163K): [in a new window]   Fig. 4B. —65-year-old woman who presented with hematuria and was previously scheduled to undergo left nephrectomy due to renal cell carcinoma. Urographic phase transverse multidetector CT image shows caliceal infiltration (arrow) from tumor (arrowheads), as confirmed by surgery.

View larger version (157K): [in a new window]   Fig. 5A. —Asymptomatic 67-year-old woman with clinical history of anemia. Transverse arterial phase multidetector CT (MDCT) image (A) shows solid lesion in left kidney (arrowheads) with small filling defect within renal vein (arrow, A), as also shown by more cranial MDCT image (arrow, B).

View larger version (152K): [in a new window]   Fig. 5B. —Asymptomatic 67-year-old woman with clinical history of anemia. Transverse arterial phase multidetector CT (MDCT) image (A) shows solid lesion in left kidney (arrowheads) with small filling defect within renal vein (arrow, A), as also shown by more cranial MDCT image (arrow, B).

View larger version (135K): [in a new window]   Fig. 5C. —Asymptomatic 67-year-old woman with clinical history of anemia. Venous infiltration (arrow) is confirmed on coronal reformatted MDCT image.

View larger version (114K): [in a new window]   Fig. 6A. —Asymptomatic 41-year-old man with 5-cm solid lesion in lower pole of left kidney that was initially detected on sonography (not shown) before multidetector CT (MDCT) was performed. Nephrographic phase coronal reformatted MDCT image shows irregularities of perinephric fat (arrow).

View larger version (144K): [in a new window]   Fig. 6B. —Asymptomatic 41-year-old man with 5-cm solid lesion in lower pole of left kidney that was initially detected on sonography (not shown) before multidetector CT (MDCT) was performed. Arterial phase oblique sagittal reformatted MDCT image shows small enhancing nodule (arrow) within perinephric fat indicating its infiltration.

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