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Evaluation of Small (≤ 3 cm) Renal Masses with MDCT: Benefits of Thin Overlapping Reconstructions

Masahiro Jinzaki1,2, Jeffrey D. McTavish1, Kelly H. Zou1, Philip F. Judy1 and Stuart G. Silverman1

1 Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.
2 Present address: Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.



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  		Fig. 1A. —Series of overlapping CT scans in 47-year-old man with renal cyst. Contrast-enhanced CT scans show 7-mm exophytic cyst (arrow) that was not detected with 5-mm-thick nonoverlapping sections, although in retrospect it is subtly visible.

 


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  		Fig. 1B. —Series of overlapping CT scans in 47-year-old man with renal cyst. CT scans show cyst (arrow) that was detected with 3-mm-thick overlapping sections.

 


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  		Fig. 2A. —31-year-old woman with pseudolesion identified on series of thin overlapping reconstructions. CT scans show structure (arrow) that was thought to be cyst when viewed using 5-mm-thick nonoverlapping sections.

 


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  		Fig. 2B. —31-year-old woman with pseudolesion identified on series of thin overlapping reconstructions. CT scans show pseudolesion (arrowheads) that was revealed to be portion of unenhanced medulla using 3-mm-thick overlapping sections. Similar structure (arrow) is seen oriented in axial plane.

 


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  		Fig. 3A. —Series of overlapping CT scans in 63-year-old man with renal masses of each group. CT scans show enhanced attenuation of 11-mm mass (long arrow) that measured 18 H on 5-mm-thick nonoverlapping sections (A) and 11 H on 3-mm-thick overlapping sections (B). Lesion was classified as cyst on both protocols (group 1). Enhanced attenuation of 8-mm mass (arrowhead) measured 49 H on 5-mm-thick non-overlapping sections (A) and 15 H on 3-mm-thick overlapping sections (B) and was therefore classified as cyst on 3-mm-thick overlapping sections only (group 2). Enhanced attenuation of 3-mm mass (short arrow) measured 83 H on 5-mm-thick nonoverlapping sections (A) and 52 H on 3-mm-thick overlapping sections (B) and thus could not be classified as cyst on either protocol (group 3).

 


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  		Fig. 3B. —Series of overlapping CT scans in 63-year-old man with renal masses of each group. CT scans show enhanced attenuation of 11-mm mass (long arrow) that measured 18 H on 5-mm-thick nonoverlapping sections (A) and 11 H on 3-mm-thick overlapping sections (B). Lesion was classified as cyst on both protocols (group 1). Enhanced attenuation of 8-mm mass (arrowhead) measured 49 H on 5-mm-thick non-overlapping sections (A) and 15 H on 3-mm-thick overlapping sections (B) and was therefore classified as cyst on 3-mm-thick overlapping sections only (group 2). Enhanced attenuation of 3-mm mass (short arrow) measured 83 H on 5-mm-thick nonoverlapping sections (A) and 52 H on 3-mm-thick overlapping sections (B) and thus could not be classified as cyst on either protocol (group 3).

 


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  		Fig. 4A. —47-year-old man with renal cell carcinoma. CT scans show enhanced attenuation of 2.3-cm mass (arrow, A) in lower pole of right kidney that measured 83 H on both 5-mm-thick nonoverlapping sections (A) and 3-mm-thick overlapping sections (B). Mass was classified as group 3, enhanced to 53 H on both protocols, and was diagnosed as renal cell carcinoma.

 


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  		Fig. 4B. —47-year-old man with renal cell carcinoma. CT scans show enhanced attenuation of 2.3-cm mass (arrow, A) in lower pole of right kidney that measured 83 H on both 5-mm-thick nonoverlapping sections (A) and 3-mm-thick overlapping sections (B). Mass was classified as group 3, enhanced to 53 H on both protocols, and was diagnosed as renal cell carcinoma.

 

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