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Lipid in renal clear cell carcinoma: detection on opposed-phase gradient-echo MR images
E K Outwater1, M Bhatia, E S Siegelman
1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5244, USA.
Purpose:
To determine if comparison of in-phase and opposed-phase gradient-echo magnetic resonance (MR) images enables detection of lipid in renal clear cell carcinoma.
Materials And Methods:
A retrospective search of MR and pathologic records identified 43 patients with biopsy-proved renal masses who underwent in-phase and opposed-phase MR imaging. Thirty-three patients had renal cell carcinoma (27 with clear cell carcinoma), and 10 patients had other renal tumors. With MR images, a region-of-interest measurement of signal intensity of the renal mass was divided by that of reference tissue. In each patient, a ratio of these region-of-interest measurements on the opposed-phase images to those on the in-phase images was calculated and termed the opposed-phase/in-phase signal intensity ratio (OIR).
Results:
The mean OIR of clear cell carcinomas was significantly different from that of other renal masses (P < .0002); in 16 (59%) of 27 patients with clear cell carcinoma, the OIR was less than 2 standard deviations below the mean OIR of other masses. In cases of clear cell carcinoma, focal signal intensity on opposed-phase images was less than that on in-phase images.
Conclusion:
On opposed-phase images, some clear cell carcinomas show relative focal and diffuse loss of signal intensity. In renal masses, this signal intensity loss-which is consistent with lipid-does not necessarily indicate angiomyolipoma.
