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CT of carcinoma of the renal pelvis
218
ABSTRACTS
rect organ of tumor origin was established in all but one patient. It is concluded that CT is excellent in showing the extent of an adrenal tumor, but is often unable to predict the organ of origin in large tumors. Angiography is still of great value in the preoperative work-up in patients with large adrenocortical carcinomas for correct identification of tumor origin and for vascular mapping. Authors’ Summary
CT OF CARCINOMA
OF THE RENAL PELVIS Nyman U, Oldbring J, Aspelin P. (Department of Diagnostic Radiology, Malmo General Hospital, S-214 01 Malmo, Sweden). Acta Radio1 1992;33:31--38. Computed tomography (CT] in 28 histologically proven carcinomas of the renal pelvis (pTa-2, n = 12; pT3-4, n = 161in 26 patients was evaluated retrospectively. Twenty-four of 28 tumors could be identified at CT, 17 of 26 at urography, and 12 of 14 at retrograde pyelography. Nineteen tumors appeared as a discrete intrapelvic mass with an attenuation close to that of the kidney on noncontrast scans. There was slight to moderate enhancement of the tumors following IV, contrast medium injection but they appeared hypodense relative to the renal parenchyma. Five tumors caused only a diffuse obliteration of the renal sinus. Criteria to define peripelvic tumor growth are proposed, that is, tumors obliterating fat planes or abutting of renal parenchyma should not be regarded as signs of extrapelvic extension, whereas inhomogeneous attenuation of peripelvic fat and renal parenchyma (in the absence of other explanation) should, or if the tumor mass is seen interdigitizing with surrounding structures. Thickening of Gerota’s fascia or septa in the perirenal space are unspecific findings. With CT we were able to differentiate tumors confined to the renal pelvic wall from those with more advanced disease including metastases in 22 of 26 patients. Authors’ Summary
DUPLEX DOPPLER ULTRASONOGRAPHY OF THE’INTRARENAL ARTERIES: NORMAL AND PATHOLOGICAL FINDINGS (In French) Sauvain JL, Bourscheid D, Pierrat V, et al. (Service d’Imagerie, Hopital Paul Morel, 46, av. Aristide Briand, F-70014 Vesoul, France). Ann Radio1 1991;34:237-247.
CLINICAL IMAGING VOL. 16, NO. 3
Duplex Doppler ultrasonography may explore renal perfusion in frequent diseases such as renal obstruction, reno-vascular hypertension, acute or chronic renal failure or diabetic renal complications by measuring Pourcelot’s resistive index (RI) of renal parenchyma arteries for each kidney. A statistical and prospective study was performed on 574 patients. In healthy patients, the RI values, equal for each kidney were included in 0.45 and 0.7 (mean RI = 0.59). For other values, there was a renal pathology. Patients with idiopathic hypertension (mean RI = 0.59) or nonobstructive dilatation (mean RI = 0.61) did not have an RI significantly different from healthy patients. In cases of renal obstruction, there was a significant increase in the RI for the pathological kidney (mean RI of 0.73). The sensitivity and the specificity was 100% for acute obstructions examined during the first 48 h. In contrast, in case of renal artery stenosis greater than 70% there was a significant decrease in the RI for pathological kidney. So the RI increased significantly in both kidneys: when there was renal failure with active disease within the tubulo-interstitial compartment (mean RI of 0.77); in all cases of diabetic nephropathy (mean RI of 0.74) in which the RI increased before laboratory signs. Duplex Doppler ultrasonography may be an original method for renal explorations by providing not only morphological data but also physiological data with the perfusion study. Authors’ Summary
OPTIMIZATION OF PROSTATIC IMAGING TECHNIQUE
RESONANCE
Poon Y, Bronskill MJ, Poon CS, et al. (Departmen of Diagnostic Imaging, St. Michael’s Hospital, 30 Bond St., Toronto, ON M5B lW8, Canada). Can Assoc Radio1 J 1991;42:423-430. With a 1.5-T magnetic resonance imager the authors systematically varied a large number of technical factors to obtain an optimum balance between high image quality and reasonable imaging time for the prostate gland. Each parameter was adjusted relative to benchmark images of very high quality to achieve a reasonable acquisition time with as little loss of the signal-to-noise ratio (SNR) as possible. Image quality was judged subjectively by magnetic resonance radiologists and objectively by measurements of SNR for the prostate. The authors recommend multislice, multiecho spin-echo pulse sequences with dual surface coils, fat suppression, reduced bandwidth, a repetition time of 1500 msec, echo times of 30 and 60
ABSTRACTS
rect organ of tumor origin was established in all but one patient. It is concluded that CT is excellent in showing the extent of an adrenal tumor, but is often unable to predict the organ of origin in large tumors. Angiography is still of great value in the preoperative work-up in patients with large adrenocortical carcinomas for correct identification of tumor origin and for vascular mapping. Authors’ Summary
CT OF CARCINOMA
OF THE RENAL PELVIS Nyman U, Oldbring J, Aspelin P. (Department of Diagnostic Radiology, Malmo General Hospital, S-214 01 Malmo, Sweden). Acta Radio1 1992;33:31--38. Computed tomography (CT] in 28 histologically proven carcinomas of the renal pelvis (pTa-2, n = 12; pT3-4, n = 161in 26 patients was evaluated retrospectively. Twenty-four of 28 tumors could be identified at CT, 17 of 26 at urography, and 12 of 14 at retrograde pyelography. Nineteen tumors appeared as a discrete intrapelvic mass with an attenuation close to that of the kidney on noncontrast scans. There was slight to moderate enhancement of the tumors following IV, contrast medium injection but they appeared hypodense relative to the renal parenchyma. Five tumors caused only a diffuse obliteration of the renal sinus. Criteria to define peripelvic tumor growth are proposed, that is, tumors obliterating fat planes or abutting of renal parenchyma should not be regarded as signs of extrapelvic extension, whereas inhomogeneous attenuation of peripelvic fat and renal parenchyma (in the absence of other explanation) should, or if the tumor mass is seen interdigitizing with surrounding structures. Thickening of Gerota’s fascia or septa in the perirenal space are unspecific findings. With CT we were able to differentiate tumors confined to the renal pelvic wall from those with more advanced disease including metastases in 22 of 26 patients. Authors’ Summary
DUPLEX DOPPLER ULTRASONOGRAPHY OF THE’INTRARENAL ARTERIES: NORMAL AND PATHOLOGICAL FINDINGS (In French) Sauvain JL, Bourscheid D, Pierrat V, et al. (Service d’Imagerie, Hopital Paul Morel, 46, av. Aristide Briand, F-70014 Vesoul, France). Ann Radio1 1991;34:237-247.
CLINICAL IMAGING VOL. 16, NO. 3
Duplex Doppler ultrasonography may explore renal perfusion in frequent diseases such as renal obstruction, reno-vascular hypertension, acute or chronic renal failure or diabetic renal complications by measuring Pourcelot’s resistive index (RI) of renal parenchyma arteries for each kidney. A statistical and prospective study was performed on 574 patients. In healthy patients, the RI values, equal for each kidney were included in 0.45 and 0.7 (mean RI = 0.59). For other values, there was a renal pathology. Patients with idiopathic hypertension (mean RI = 0.59) or nonobstructive dilatation (mean RI = 0.61) did not have an RI significantly different from healthy patients. In cases of renal obstruction, there was a significant increase in the RI for the pathological kidney (mean RI of 0.73). The sensitivity and the specificity was 100% for acute obstructions examined during the first 48 h. In contrast, in case of renal artery stenosis greater than 70% there was a significant decrease in the RI for pathological kidney. So the RI increased significantly in both kidneys: when there was renal failure with active disease within the tubulo-interstitial compartment (mean RI of 0.77); in all cases of diabetic nephropathy (mean RI of 0.74) in which the RI increased before laboratory signs. Duplex Doppler ultrasonography may be an original method for renal explorations by providing not only morphological data but also physiological data with the perfusion study. Authors’ Summary
OPTIMIZATION OF PROSTATIC IMAGING TECHNIQUE
RESONANCE
Poon Y, Bronskill MJ, Poon CS, et al. (Departmen of Diagnostic Imaging, St. Michael’s Hospital, 30 Bond St., Toronto, ON M5B lW8, Canada). Can Assoc Radio1 J 1991;42:423-430. With a 1.5-T magnetic resonance imager the authors systematically varied a large number of technical factors to obtain an optimum balance between high image quality and reasonable imaging time for the prostate gland. Each parameter was adjusted relative to benchmark images of very high quality to achieve a reasonable acquisition time with as little loss of the signal-to-noise ratio (SNR) as possible. Image quality was judged subjectively by magnetic resonance radiologists and objectively by measurements of SNR for the prostate. The authors recommend multislice, multiecho spin-echo pulse sequences with dual surface coils, fat suppression, reduced bandwidth, a repetition time of 1500 msec, echo times of 30 and 60