Multiphasic CT enhancement patterns of various renal neoplasms: usefulness and correlations with histopathology
Patel VA, Sutariya HC, Jain RJ, Patel SA
Background: CT scan plays a major role in diagnosis of renal cancers and characterizing its different subtypes. Aim: Our study aimed to study the diagnosed or suspicious renal mass lesions with Multi detector computed tomography and obtain information regarding their enhancement pattern in various phases of CT scan with emphasis on HU density and correlation with histo-pathological findings. Methods and Material: Approximately 60 patients with diagnosed or suspicious renal masses were included in the study and images were examined with emphasis on enhancement patterns and density in Hounsefield units (HU) in different phases of study. The diagnosis was then correlated with the histo-pathological findings. Results: In our study including 60 renal cell carcinoma lesions (RCC), most of them were clear cell RCC; and other types included papillary, chromophobe, and oncocytoma variants. About 5 lesions showed diagnosis other than renal cell carcinoma. Clear cell RCC showed more enhancement in arterial phase (51.5-147.5 HU) than unenhanced phase (26-104 HU) and de enhancement in venous phase (40-122 HU). Papillary RCC showed maximum enhancement in venous phase (66-117.5 HU) than unenhanced (26-99 HU) and arterial phases (55-76 HU). The pattern of enhancement in context to HU density in various subtypes of RCC vary and in comparison to clear cell RCC, each type shows variable density [Table 2]. Conclusions: Density in Hounsefield units on CT scan within the mass lesion in various phases reflects the pattern of enhancement of the mass and hence can give a clue about the type of the mass lesion.