Angiomyolipoma: Imaging Findings in Lesions With Minimal Fat

Jinzaki, Masahiro; Tanimoto, Akihiro; Narimatsu, Y; Ohkuma, Kiyoshi; Kurata, Tadao; Shinmoto, Hiroshi; Hiramatsu, Kazuhiro; Mukai, Makio; Murai, Masaru

doi:10.1016/s0022-5347(01)63635-8

Cited by 40 publications

(64 citation statements)

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“…Using a combination of grey-scale and power Doppler ultrasonographic modes, Jinzaki et al [39] evaluated a cohort of patients with small (1.5-3 cm) renal lesions consisting of renal cell carcinomas, angiomyolipomas, oncocytomas, and pseudotumors. Grey-scale ultrasound exhibited an extremely poor diagnostic accuracy (21%) for angiomyolipomas, though the combination of gray-scale and power Doppler ultrasound increased the diagnostic accuracy.…”

Section: New Insights Into Abdominal Imaging For the Tsc Patientmentioning

confidence: 99%

Tuberous sclerosis complex renal disease

Dixon¹,

Kingswood²,

Bissler³

2015

Oxford Medicine Online

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and intractable epilepsy), less than 40% of affected patients have all three features [3] . TSC most often presents with neurologic symptoms, and approximately 90% of affected individuals experience seizures and about half of patients experience cognitive impairment, autism, or other behavioral disorders. Renal manifestations are the second most common findings associated with TSC, with angiomyolipomas occurring in 80% and renal cystic disease in ϳ 50% of patients. Pulmonary involvement, specifically lymphangioleiomyomatosis (LAM), is the third most common cause of TSC-associated morbidity, occurring in approximately 35% of female TSC patients. The gender predilection in LAM is not understood.TSC is caused by mutations in either the TSC1 gene, located on chromosome 9, or the TSC2 gene, located on chromosome 16. Typically children with TSC are born with normal kidneys but develop cystic disease and angiomyolipomas as they age. Both renal cystic disease and angiomyolipomas cause chronic kidney disease (CKD), affecting approximately one million patients with TSC worldwide. Renal disease poses a significant burden on patients with TSC because of the relentless progression, morbidity, and mortality of CKD. In fact, using death certificate data Shepherd et al. [4] identified renal failure as the leading cause of death in their adult patients at the Mayo Clinic. Key WordsTuberous sclerosis complex ؒ Angiomyolipoma ؒ Renal cyst ؒ Oncocytoma ؒ Mammalian target of rapamycin complex 1 ؒ Rapamycin ؒ Sirolimus AbstractAlthough not as common as other genetic renal diseases such as autosomal dominant polycystic kidney disease, patients with tuberous sclerosis complex frequently have significant renal involvement. Recent revelations in the cell biology of these renal disease manifestations as well as effective therapies for tuberous sclerosis complex-related renal issues have heralded hope of improved renal survival and improved quality of life for the TSC patient. This review specifically addresses some of the major renal manifestations of this disease.

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Section: New Insights Into Abdominal Imaging For the Tsc Patientmentioning

confidence: 99%

Tuberous sclerosis complex renal disease

Dixon¹,

Kingswood²,

Bissler³

2015

Oxford Medicine Online

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“…Both papillary carcinomas and angiomyolipomas tend to be T2-hypointense compared with the adjacent renal parenchyma, while clear cell carcinomas are iso-to hyperintense (36)(37)(38). Furthermore certain features such as the presence of intralesional fat are characteristic of angiomyolipomas.…”

Section: Genitourinary Imaging: Renal Cortical Tumorsmentioning

confidence: 99%

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Vargas

Chaim²,

Lefkowitz³

et al. 2012

Radiology

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Purpose:To investigate the use of quantitative multiphasic contrast material-enhanced magnetic resonance (MR) imaging in differentiating between common benign and malignant histologic subtypes of renal cortical tumors. Materials and Methods:The institutional review board waived informed consent and approved this retrospective HIPAA-compliant study of 138 patients who underwent preoperative contrastenhanced MR imaging during the period of January 2004-December 2008. At surgery, 152 renal tumors were identified (77 clear cell, 22 papillary, 18 chromophobe, and 10 unclassified carcinomas; 16 oncocytomas; nine angiomyolipomas). Three readers independently identified and measured the most-enhanced area in each tumor and placed corresponding regions of interest in similar positions on images from the precontrast, corticomedullary, nephrographic, and excretory phases. The percentage change in signal intensity (%SI change) between precontrast imaging and each postcontrast phase was calculated.Interreader agreement was evaluated by using the overall concordance correlation coefficient (OCC). A linear mixed-effects model was used to estimate and compare the trajectories of the means of log %SI change across all phases between the six histologic subtypes. results:Interreader agreement was substantial to almost perfect (OCC, 0.77-0.88). The %SI change differed significantly between clear cell carcinomas and papillary and chromophobe carcinomas in all phases of enhancement (P , .0001-.0120). In addition, %SI change was significantly higher in angiomyolipomas than in clear cell carcinomas, but only in the corticomedullary phase (P = .0231). Enhancement did not differ significantly between clear cell carcinoma and oncocytoma in any phase (P = .2081-.6000). conclusion:Quantitative multiphase contrast-enhanced MR imaging offers a widely available, reproducible method to characterize several histologic subtypes of renal cortical tumors, although it does not aid differentiation between clear cell carcinomas and oncocytomas.q RSNA, 20121 From the Departments of Radiology (H

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] Despite these advancements, some cases still remain for which CT or MRI cannot be used for the histological characterization of a renal tumor. For example, the differentiation of RCC from AML and infiltrating UC of the kidney can be difficult in some cases.…”

Section: Introductionmentioning

confidence: 99%

Utility of Apparent Diffusion Coefficients in the Evaluation of Solid Renal Tumors at 3T

Sasamori

Saiki

Suyama

et al. 2014

MRMS

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Purpose: We assessed the usefulness of apparent diffusion coefficients (ADCs) for solid renal tumor imaging using diffusion-weighted magnetic resonance imaging (DWI) at 3T.Methods: This retrospective study assessed ADCs of 31 patients with renal tumors that were imaged using preoperative DWI. DWI was performed with the b values of 50, 500, and 1000 s/mm 2 , using a 3T magnetic resonance imaging (MRI) system (MAGNETOM Trio, 3T, Siemens Healthcare, Erlangen, Germany). The ADC map was calculated using the b values of 50 and 1000 s/mm 2 . ADCs of the different tumors were compared according to the Tukey-Kramer test.Results: The tumors were diagnosed as clear cell renal cell carcinoma (RCC; n = 20), papillary RCC (n = 1), infiltrating urothelial carcinoma (UC) of the kidney (n = 4), cystic RCC (n = 1), poorly differentiated carcinoma (n = 1), and angiomyolipoma (AML; n = 4). The mean ADC of clear cell RCC was significantly higher than that of infiltrating UC of the kidney (1.423 vs. 0.931 © 10 ¹3 mm 2 /s; P < 0.05), and the mean ADC of AML was significantly lower than that of clear cell RCC (0.674 vs. 1.423 © 10 ¹3 mm 2 /s; P < 0.01). Conclusion: ADCs used in DWI at 3T may be useful for differentiation of different types of solid renal tumors.

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Angiomyolipoma: Imaging Findings in Lesions With Minimal Fat

Cited by 40 publications

References 0 publications

Tuberous sclerosis complex renal disease

Tuberous sclerosis complex renal disease

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Utility of Apparent Diffusion Coefficients in the Evaluation of Solid Renal Tumors at 3T

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