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MR Imaging of Renal Masses: Correlation with Findings at Surgery and Pathologic Analysis¹

¹ From the Departments of Radiology (I.P., M.R.S., M.S., N.M.R.), Pathology (E.M.G.), and Surgery (A.F.O., W.C.D.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215. Recipient of an Excellence in Design award for an education exhibit at the 2003 RSNA Annual Meeting. Received February 14, 2006; revision requested March 24; final revision received August 20, 2007; accepted September 11. N.M.R. receives research support from GE Healthcare and Bayer (Berlex), is a consultant with EPIX Pharmaceuticals, and is on the advisory boards of Bayer (Berlex) and CAD Sciences; all remaining authors have no financial relationships to disclose. Address correspondence to I.P. (e-mail: ipedrosa{at}bidmc.harvard.edu).

Magnetic resonance (MR) imaging is useful in the characterization of renal masses. The MR imaging manifestations and pathologic diagnoses of 82 renal masses were reviewed and correlated. The MR imaging appearance of clear cell type renal cell carcinoma varies depending on the presence of cystic components, hemorrhage, and necrosis. Papillary renal cell carcinomas appear as well-encapsulated masses with homogeneous low signal intensity on T2-weighted images and homogeneous low-level enhancement after the intravenous administration of contrast material, or as cystic hemorrhagic masses with peripheral enhancing papillary projections. Transitional cell carcinoma may be seen as an irregular, enhancing filling defect in the pelvicaliceal system or ureter. Lymphomatous masses are usually hypointense relative to the renal cortex on T2-weighted images and enhance minimally on delayed gadolinium-enhanced images. Bulk fat is a distinguishing feature of angiomyolipoma. Oncocytoma has a variable and nonspecific appearance at MR imaging. MR imaging findings may allow the characterization of various renal masses and can provide valuable information for their clinical management.

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