ABSTRACT
BACKGROUND: To describe the appearance of renal masses during multiphase helical computed tomography (CT) acquisition and evaluate the impact of a cortical nephrographic phase on diagnosis. METHODS: The CT examinations of 33 patients with 37 lesions [18 renal cell carcinomas (RCC), nine solid tumors, 10 cystic lesions] were reviewed to characterize renal masses during four phases of CT scanning: plain, cortical nephrographic, tubular nephrographic, and pyelographic. Two reviewers analyzed all lesions on the complete data set, and a third reviewer analyzed three combinations of images separately: (1) plain and tubular nephrographic phases, (2) plain and cortical nephrographic phases, and (3) three phases combined. Receiver operating characteristics (ROC) curves were generated to determine the respective value of each combination in lesion characterization. RESULTS: During the cortical nephrographic phase, hyperdensity of solid renal masses was 100% specific and 22% sensitive for RCC, whereas combining hyperdense and isoattenuating heterogeneous masses was 91% specific and 56% sensitive. ROC curves demonstrated a sensitivity of 85%, 90%, 100% for the three combinations, respectively, with a constant specificity of 88% for diagnosing RCC. CONCLUSION: The cortical nephrographic phase is useful to characterize renal masses and should be included in the routine helical CT protocol.
Subject(s)
Kidney Diseases/diagnostic imaging , Tomography, X-Ray Computed , Abscess/diagnostic imaging , Abscess/pathology , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/secondary , Adenoma, Oxyphilic/diagnostic imaging , Adenoma, Oxyphilic/pathology , Adult , Aged , Angiomyolipoma/diagnostic imaging , Angiomyolipoma/pathology , Biopsy , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/pathology , Carcinoma, Transitional Cell/diagnostic imaging , Carcinoma, Transitional Cell/pathology , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Kidney Diseases/pathology , Kidney Diseases, Cystic/diagnostic imaging , Kidney Diseases, Cystic/pathology , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/pathology , Kidney Neoplasms/secondary , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Male , Middle Aged , Retrospective Studies , Sensitivity and SpecificitySubject(s)
Infarction/diagnosis , Omentum/blood supply , Diagnosis, Differential , Female , Humans , Infarction/pathology , Middle Aged , Omentum/diagnostic imaging , Omentum/pathology , Peritoneal Diseases/diagnosis , Peritoneal Diseases/pathology , Tomography, X-Ray Computed , Torsion Abnormality/diagnosis , Torsion Abnormality/pathology , UltrasonographyABSTRACT
The "double condom sign," on a plain film of the abdomen, can be used to identify smugglers who are concealing non-opaque narcotics within the gastrointestinal tract.
