Small (< or = 3 cm) renal masses: correlation of spiral CT features and pathologic findings.

Abstract

OBJECTIVE.We describe our 3-year experience using spiral CT in the evaluation of small renal masses in order to determine the usefulness of this technique for classifying the lesions and to correlate specific CT features with pathologic findings. MATERIALS AND METHODS

The small renal mass: detection, characterization, and management

“…In addition, enhancement of most of these small RCCs is greater than 20 HU after the intravenous injection of contrast material (Fig. 5) [19]. Unfortunately, enhancement to a lesser degree is fairly nonspecific and can indicate either a benign lesion or a hypovascular neoplasm.…”

“…Many small renal masses lack obvious aggressive features with visual inspection alone [18]. Although enhancement greater than 10 Hounsfield units (HU) is a standard cutoff for separating benign from malignant renal masses, up to 50% of renal masses with this level of enhancement are benign [19]. Alternatively, masses with enhancement greater than 20 HU after the injection of contrast material are nearly always malignant [19].…”

“…Although enhancement greater than 10 Hounsfield units (HU) is a standard cutoff for separating benign from malignant renal masses, up to 50% of renal masses with this level of enhancement are benign [19]. Alternatively, masses with enhancement greater than 20 HU after the injection of contrast material are nearly always malignant [19]. The majority of small RCCs appear solid or have mixed solid and cystic components.…”

“…The majority of small RCCs appear solid or have mixed solid and cystic components. These lesions usually have relatively high attenuation values (ú20 HU) on CT scans before contrast material infusion [19]. In addition, enhancement of most of these small RCCs is greater than 20 HU after the intravenous injection of contrast material (Fig.…”

“…With helical CT, reformatting of the image slices with overlapping thin reconstruction may be useful to minimize partial-volume averaging artifacts. However, one study of this technique failed to demonstrate any advantage over standard thin-section CT for characterization of renal masses [19]. Helical CT does appear superior to conventional CT for fat detection in small AMLs [20].…”