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Fig. 7. —54-year-old man who presented with bilateral leg swelling and
was referred for MRI for preoperative staging of renal mass in left kidney
detected on CT scan obtained at another hospital. Coronal venous phase
gadolinium-enhanced 3D spoiled gradient-echo T1-weighted image (TR/TE,
6.3/2.3; flip angle, 12°) shows large renal mass in left kidney with
enhancing tumor thrombus extending above and below (arrowheads) short
segment of uninvolved inferior vena cava. Note tumor thrombus extension
through retroaortic renal vein (solid arrow) into inferior vena cava.
Nonenhancing, low-signal-intensity bland thrombus is seen in inferior vena
cava below tumor thrombus (open arrow). Tumor thrombus in proximal
inferior vena cava extends to level of diaphragm (level III). These findings
were confirmed at surgery.
