Appliciation of Magnetic Resonance in Imaging of Renal Carcinomas
in Patients with Terminal Kidneys Failure
Ferda J.1, Hora M.2, Hes O.3, Ürge T.2, Reischig T.4, Mírka H.1, Ferdová E.1, Kreuzberg B.1, Ohlídalová K.1
Radiodiagnostická klinika LF UK a FN, Plzeň1 přednosta doc. MUDr. B. Kreuzberg, CSc. Urologická klinika LF UK a FN, Plzeň2 přednosta doc. MUDr. M. Hora, PhD. Šiklův ústav patologické anatomie LF UK a FN, Plzeň3 přednosta prof. MUDr. M. Michal I. interní klinika LF UK a FN, Plzeň4 přednosta prof. MUDr. K. Opatrný jr., DrSc. |
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Summary:
Introduction: In comparison to the normal population, the incidence of the renal carcinoma,
frequently multiple, is 6 times higher in patients in terminal phase of the renal
failure. In cases of the renal transplantation and immunosuppression, the behavior of
the renal carcinoma might be more aggressive.
Material and method: Five male patients underwent the magnetic resonance examination
for a suspected tumor of their kidney. Three patients were after renal allograft
transplantation, one newly dialyzed and one long term dialyzed respectively. In one
patient, the nephrectomy due to the tumor was performed in the past. The T2-weighted HASTE sequence, diffusion weighted echo planar imaging and dynamic post contrast
T1 weighted 3D spoiled GRE were used.
Results: In nephrectomy confirmed tumors were identified in all sequences. The combination
of the lower signal in T2 HASTE, DWI than in cysts and enhancement after
gadolinium administration in T1 GRE was the typical sign of all tumors. In all four operated
on patients, tumors were confirmed in the resected kidneys. The hypertrophy of
the remained renal parenchyma was found in one case and the tumor was found in
other place of the same kidney. The well-differentiated liposarcoma of the renal capsula
was found in one case. Local tumor recurrence in one patient previously operated
on for tumor was found.
Conclusion: MRI protocol composed of T2, DWI and dynamic gadolinium enhanced T1
weighted images is sufficient noninvasive imaging tool to detect tumors of the own
kidneys in patients with end-stage renal disease.
Key words:
renal carcinoma – end-stage renal disease – kidney transplantation
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