Ultrasonography and tomodensitometry staging of kidney tumors: anatomo-radiologic correlations in 46 patients

• Published in: Progrès en urologie (Paris) Vol. 5; no. 6; p. 951
• Main Authors: Boyer, L, Ajavon-Dutin, B, Bagard, C, Boissier, A, Manoukian, W, Kemeny, J L, Boiteux, J P, Giraud, B, Viallet, J F
• Format: Journal Article
• Language: French
• Published: France 01-12-1995
• Subjects: Adult; Aged; Aged, 80 and over; False Negative Reactions; False Positive Reactions; Female; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - pathology; Lymphatic Metastasis; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Invasiveness; Renal Veins; Sensitivity and Specificity; Tomography, X-Ray Computed
• ISSN: 1166-7087

To comparatively evaluate CT scan and MRI in the preoperative staging of renal tumours.
46 patients with a solid renal tumour were investigated preoperatively by CT scan (n = 43) and MRI (n = 46), the results of which were compared with pathological data.
MRI assessed capsular effraction with a sensitivity of 95.6% and a specificity of 52.1%, versus 95.2 and 40%, respectively, for CT scan. Three cases of perirenal extension were detected by MRI. The sensitivity of MRI was higher than that of CT scan for the demonstration of adenopathy (71.4% versus 57.1%) with specificities of 92.3 and 88.8%, respectively. Fourteen cases were associated with tumour extension into the proximal renal vein, which extended into the distal segment of this vein in 12 cases, into the inferior vena cava in 6 cases and as far as the right atrium in 2 cases. The performance of MRI was always better than that of CT scan in relation to venous segments of surgical interest (respective sensitivities of 70% and 83.33% in the distal renal vein and 66.6% and 83.33% in the inferior vena cava: and respective specificities of 84.8% and 97% in the distal renal vein and 91.8% and 97.5% in the inferior vena cava), provided the results of T1-weighted spin echo sequences and FLASH gradient echo sequences were assessed conjointly.
These results lead us to now prefer MRI to CT scan for the preoperative staging of renal cancer, in the presence of a contraindication to iodinated contrast agent injection, very large tumours, and whenever venous extension is suspected on ultrasonography.