Nuclear magnetic resonance imaging of the kidney: renal masses

Fifteen patients with a variety of renal masses were examined by nuclear magnetic resonance (NMR), computed tomography, ultrasound, and intravenous urography. NMR clearly differentiated between simple renal cysts and other renal masses. On spin echo images, the simple renal cyst appeared as a round or slightly oval, homogeneous low-intensity mass with characteristically long T1 and T2 values. The thickness of the cyst wall was not measurable. The cyst had a smooth outer margin and a distinct, sharp interface with normal parenchyma. Hemorrhagic cysts were seen as high-intensity lesions. Renal cell carcinomas displayed a wide range of intensity. The T1 and T2 values of the tumors were always different from those of the surrounding renal parenchyma. Tumor pseudocapsule was identified in four of five patients examined. All carcinomas were accurately staged by NMR and extension of the tumor thrombus into the inferior vena cava was demonstrated. The authors predict that if these preliminary results are confirmed by data from a larger number of patients, NMR will play a significant role in renal imaging.