iothalamate-meglumine and Kidney-Neoplasms

To evaluate thin-section computed tomography (CT) performed during the corticomedullary and nephrographic phases of contrast material enhancement in the characterization of renal masses.. A prospective study of 30 patients was undertaken with CT to characterize 31 "indeterminate" renal masses. In all patients, 5-mm-thick, contiguous, high-tube-current (320-340-mA) scans were obtained through the kidneys before (axial mode), during (helical mode, 25-second delay, corticomedullary-phase images), and after (axial mode, 120-second delay, nephrographic-phase images) administration of a 117-second biphasic injection of intravenous contrast material.. Eight of 16 neoplasms measured less than 20 HU on CT scans obtained without contrast material enhancement; measurements of two of these corresponded to "cyst attenuation" during the corticomedullary phase. Enhancement of 10 HU or greater was demonstrated in 11 neoplasms during the corticomedullary phase and in all neoplasms in the nephrographic phase. No enhancement was seen in 15 radiologically benign cysts. Both renal neoplasms and normal renal cortex demonstrated significantly greater enhancement in the nephrographic phase compared with that in the corticomedullary phase (P = .0002 and P < .0001, respectively).. Enhancement of renal neoplasms is time dependent and may not be evident in hypovascular tumors analyzed during the early corticomedullary phase. Reliance on absolute CT attenuation measurements, without use of internal standards as controls, may lead to misdiagnosis of neoplasms as cysts.

Topics: Adult; Aged; Contrast Media; Female; Humans; Iothalamate Meglumine; Kidney; Kidney Cortex; Kidney Diseases, Cystic; Kidney Medulla; Kidney Neoplasms; Male; Middle Aged; Prospective Studies; Tomography, X-Ray Computed

To follow up the growth of renal angiomyolipomas (AMLs).. Patients with known AML (n = 55) were divided into three groups on the basis of initial clinical and computed tomographic (CT) findings: group 1, isolated AML (n = 43); group 2, multiple AMLs without tuberous sclerosis (TS) (n = 6); group 3, multiple AMLs with TS (n = 6). Follow-up ultrasonography (US) and CT were performed in 55 and 31 patients, respectively. Growth of the AMLs (n = 59) was evaluated on the basis of area on initial and follow-up images.. Mean percentage growth was 17%, 128%, and 47%, and mean growth rate per year was 5%, 22%, and 18% in groups 1, 2, and 3, respectively. New renal lesions were noted in three patients in groups 1 and 2, but no new lesions were detected in group 3, because of the large number of AMLs. New extrarenal lesions were observed in four, two, and three patients in groups 1, 2, and 3, respectively. No correlation was found between percentage of fatty tissue and growth rate.. Multiple AMLs show more growth than solitary AMLs.

Topics: Adipose Tissue; Adult; Aged; Aged, 80 and over; Angiomyolipoma; Contrast Media; Female; Follow-Up Studies; Humans; Iothalamate Meglumine; Kidney Neoplasms; Liver Neoplasms; Male; Middle Aged; Radiographic Image Enhancement; Splenic Neoplasms; Tomography, X-Ray Computed; Tuberous Sclerosis; Ultrasonography