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Related Experiment Videos

Complex renal cysts: findings on MR imaging.

N C Balci1, R C Semelka, R H Patt

  • 1Department of Radiology, University of North Carolina, Chapel Hill 27599-7510, USA.

AJR. American Journal of Roentgenology
|June 1, 1999
PubMed
Summary

Mural irregularity and intense enhancement on MR imaging strongly predict malignancy in complex renal cysts. However, distinguishing benign from malignant lesions remains challenging in some cases.

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Area of Science:

  • Radiology
  • Oncology
  • Urology

Background:

  • Complex cystic renal masses require accurate differentiation between benign and malignant entities.
  • Magnetic Resonance (MR) imaging is a key modality for evaluating renal lesions.

Purpose of the Study:

  • To retrospectively assess MR imaging features for distinguishing benign from malignant complex cystic renal masses.
  • To identify specific imaging characteristics associated with malignancy.

Main Methods:

  • Retrospective review of 37 patients with 55 complex cystic renal lesions.
  • Analysis of T1-weighted, T2-weighted, and gadolinium-enhanced MR images (1.5-T).
  • Inclusion criteria: heterogeneous cyst fluid, mural irregularity, septa, mural masses/nodules, increased mural thickness, or intense mural enhancement.

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Main Results:

  • Mural irregularity (63%), mural masses/nodules (75%), thick walls (71%), and intense mural enhancement (44%) were associated with malignancy.
  • The combination of mural irregularity and intense mural enhancement showed the highest correlation with malignancy (p = .0002).

Conclusions:

  • Mural irregularity and intense mural enhancement are significant predictors of malignancy in complex renal cystic lesions.
  • Despite strong predictors, overlap exists, making definitive separation challenging in all cases via MR imaging.