Renal oncocytoma MRI
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Renal oncocytoma MRI On the Web |
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American Roentgen Ray Society Images of Renal oncocytoma MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2] Shanshan Cen, M.D. [3]
Overview
MRI may be helpful in the diagnosis of renal oncocytoma.
MRI
Typical signal characterisitics include:[1]
- T1 weighted image:
- Hypointense compared to renal cortex
- T2 weighted image:
- Hyperintense compared to renal cortex
- May demonstrate hypointense central stellate scar
- T1 with gadolinium contrast:
- Usually demonstrates homogeneous enhancement
Overview
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
MRI
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include:
- [Finding 1]
- [Finding 2]
- [Finding 3]
OR
There are no MRI findings associated with [disease name]. However, an MRI may be helpful in the diagnosis of complications of [disease name], which include:
- [Complication 1]
- [Complication 2]
- [Complication 3]
Radiologic differentiation of oncocytoma from RCC
would be invaluable prior to surgery since it may change the
management. Nephron sparing surgery can be used for large
tumors. There are some radiologic features that might be noticed
in oncocytomas but they are not specific to this type of
tumor. A central scar or stellate pattern can be observed in
27% to 54% of the tumors [6,28,29]. However, the central
scar sometimes cannot be differentiated from a central necrosis
that may be noticed with RCC even with MRI since
both lesions may have low signal on T1 and high signal on
T2 sequences [30]. Pedrosa et al. reported that delayed
enhancement of the central scar may be seen with MRI after
gadolinium administration, a feature that is not noticed with
central necrosis [31]. Pseudo-capsule may be seen in 40% to
45% of oncocytomas [29,32]. However it may be noticed in
up to 60% of RCC as well [29]. Davidson et al. [33]
concluded from their series (53 tumors in 48 patients) that
features such as homogenous enhancements and central
stellate scar are poor predictors of oncocytomas on computerized
tomography (CT) scans. Among oncocytomas larger
than 3 cm, only two-thirds fulfilled the criteria for oncocytoma,
whereas among RCC smaller than 3 cm, 42% had
radiologic criteria consistent with oncocytomas. Choudhary
et al. [34] made a retrospective study of 28 oncocytomas
and searched for CT features that could identify oncocytomas.
The authors could not find features that were pathognomonic
for oncocytomas.
Wildberger et al. [35] made a retrospective study in
which seven radiologists retrospectively reviewed the preoperative
CT scans of 7 patients with renal masses diagnosed
as oncocytomas. The radiographic diagnosis was correct
in 12% of 49 cases.
Pretorius et al. searched for MR features that may distinguish
oncocytoma from RCC. However, similar to CT
scans, the authors found a significant overlap between the MR
features of oncocytomas and RCCs, making the primary
radiologic diagnosis of oncocytoma not feasible with this
method [29]
References
- ↑ Renal oncocytoma.Dr Donna D'Souza et al. Radiopaedia.org 2015.http://radiopaedia.org/articles/renal-oncocytoma