Evaluation of renal masses with contrast-enhanced rapid acquisition spin echo MR imaging

• Published in: Magnetic resonance imaging Vol. 11; no. 1; pp. 7 - 16
• Main Authors: Eilenberg, Steven S., Brown, Jefferey J., Lee, Joseph K.T., Heiken, Jay P., Mirowitz, Scott A.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1993; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Renal Cell - diagnosis; Carcinoma, Renal Cell - epidemiology; Contrast Media; Drug Combinations; Female; Gadolinium; Gadolinium DTPA; Hamartoma - diagnosis; Hamartoma - epidemiology; Humans; Investigative techniques, diagnostic techniques (general aspects); Kidney - diagnostic imaging; Kidney - pathology; Kidney Diseases, Cystic - diagnosis; Kidney Diseases, Cystic - epidemiology; Kidney Neoplasms - diagnosis; Kidney Neoplasms - epidemiology; Kidney neoplasms, MR studies; Kidney, MR studies; Magnetic Resonance Imaging - instrumentation; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging - statistics & numerical data; Male; Medical sciences; Meglumine; Middle Aged; Observer Variation; Organometallic Compounds; Pentetic Acid; Radiodiagnosis. Nmr imagery. Nmr spectrometry; ROC Curve; Time Factors; Tomography, X-Ray Computed - instrumentation; Tomography, X-Ray Computed - methods; Tomography, X-Ray Computed - statistics & numerical data; Urinary system; Kidney neoplasms, diagnosis; Kidney neoplasms, MR studies; Kidney, MR studies; Human; Pseudotumor; Radiodiagnosis; Respiratory disease; Exploration; Spin echo; Biophysics; Malignant tumor; Contrast; Nuclear magnetic resonance imaging; Optimization; Kidney; Characterization; Cyst; Detection
• ISSN: 0730-725X; 1873-5894
• DOI: 10.1016/0730-725X(93)90406-4

To assess the use of dynamic contrast-enhanced rapid acquisition spin-echo (RASE) imaging for the detection and characterization of renal masses, we evaluated 18 patients with CT evidence of 67 renal masses. The masses included 58 simple cysts, 8 solid neoplasms, and 1 pseudotumor. Patients were examined with standard spin-echo (SE) pulse sequences including pre- and postcontrast T 1-weighted images and noncontrast T 2-weighted images as well as pre- and postcontrast RASE images. Each pulse sequence was reviewed individually and in a group with other pulse sequences by two blinded observers. The performance of contrast-enhanced RASE imaging either alone or in combination with a T 2-weighted SE sequence resulted in improved diagnostic accuracy compared with unenhanced conventional SE and RASE sequences. The contrast-enhanced RASE sequence outperformed the contrast-enhanced T 1-weighted SE sequence for one observer; similar diagnostic accuracy was achieved with the two examinations by the other observer. Combining the T 2-weighted sequence with contrast-enhanced RASE images did not increase lesion detection but did increase the observers' confidence in making the diagnosis. Contrast-enhanced MR imaging resulted in significant improvement in the detection and characterization of renal lesions compared to unenhanced MR imaging.