Magnetic Resonance Imaging Features of a Juxtaglomerular Cell Tumor.
Suhai Kang, Aitao Guo, Haiyi Wang, Lu Ma, Zongyu Xie, Jinglong Li, Xinyuan Tonge, Huiyi Ye
Department of Radiology, Department of Pathology, Statistical Teaching and Research Section, Chinese PLA General Hospital, Beijing, Department of Radiology, First Affiliated Hospital of Bengbu Medical College, Anhui Province, Department of MRI, First Hospital of Qinhuangdao, Hebei Province, PR China
Date of Submission: 18-Nov-2015, Date of Acceptance: 23-Dec-2015, Date of Web Publication: 31-Dec-2015.
Objective: To retrospectively determine whether magnetic resonance imaging (MRI) findings can help differentiate a juxtaglomerular cell tumor (JCT) from clear cell renal cell carcinoma (ccRCC). Materials and Methods: Eight patients with JCTs and 24 patients with pathologically proven ccRCC were included for image analysis. All patients underwent unenhanced MRI and dynamic contrast-enhanced MRI. Fat-suppressed T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), in- and opposed-phase imaging, and fat-suppressed preliver acquisitions with volume acceleration sequences were performed before enhancement. After the administration of contrast, dynamic imaging was performed in the corticomedullary, nephrographic, and excretory phases. Student’s t-test, t′-test, Chi-square test, and nonparametric Kruskal–Wallis H-test were used to determine the significance of the difference between the two groups. The sensitivity and specificity of the MRI findings were calculated. Results: In patients with a JCT, a cystic part of the lesion of <10%, isointensity or mild hyperintensity on T2WI, heterogeneous hyperintensity on DWI, less signal drop (<10%) in in- and opposed-phase imaging, and a degree of enhancement <200% in the corticomedullary phase showed statistically significant differences compared with those of ccRCC (P < 0.05). After combining a lower apparent diffusion coefficient (ADC) value (heterogeneous hyperintensity) on DWI and a degree of enhancement <200% in the corticomedullary phase using a parallel test, the sensitivity and specificity were 90.9% and 91.7%, respectively. Conclusions: Isointensity or mild hyperintensity on T2WI, a lower ADC value (heterogeneous hyperintensity) on DWI, and a degree of enhancement <200% in the corticomedullary phase are the major MRI findings for JCTs, combined with relative clinical manifestations and excluding other renal masses. A main solid tumor, less signal drop (<10%) in in- and opposed-phase imaging, and a less-washout pattern of <10% in the delayed phase are secondary MRI findings for JCTs.
Anne-Laure Faucon, Camille Bourillon, Christine Grataloup, Stéphanie Baron, Pauline Bernadet-Monrozies, Emmanuelle Vidal-Petiot, Michel Azizi and Laurence Amar (2019) Usefulness of Magnetic Resonance Imaging in the Diagnosis of Juxtaglomerular Cell Tumors: A Report of 10 Cases and Review of the Literature. American Journal of Kidney Diseases73(4):566. doi: 10.1053/j.ajkd.2018.09.005
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