Abstract:Diffusion-weighted (DW) magnetic resonance imaging (MRI) is a functional imaging technique that derives image contrast from differences in water molecule diffusion within tissues. DW MRI helps detect and characterize renal and urothelial malignancies, may help in differentiating some benign from malignant renal masses, and can also recognize renal and upper urinary tract infections. Patients precluded from receiving intravenous contrast agents may particularly benefit from this technique.
“…For those who are not suitable for CT urography, similar MR imaging protocols exist [46]. Investigators have found that by adding diffusion-weighted imaging, the accuracy and sensitivity for detecting UTUC at MRI can be significantly improved, and this may be a useful adjunct in preoperative assessments of tumor grade or aggressiveness [47]. PET/CT scans have been found to be highly sensitive for primary and metastatic bladder and upper tract TCC [48,49].…”
“…For those who are not suitable for CT urography, similar MR imaging protocols exist [46]. Investigators have found that by adding diffusion-weighted imaging, the accuracy and sensitivity for detecting UTUC at MRI can be significantly improved, and this may be a useful adjunct in preoperative assessments of tumor grade or aggressiveness [47]. PET/CT scans have been found to be highly sensitive for primary and metastatic bladder and upper tract TCC [48,49].…”
“…There may be resultant hydronephrosis depending on the location of the tumor [ 30 ]. On MRI, the tumor may appear isointense to slightly hypointense on T1 weighted imaging, isointense to mildly hyperintense on T2 weighted imaging, with mild, heterogenous enhancement post-contrast [ 31 ]. Fig.…”
Lymphomatous involvement of the genitourinary system, particularly the kidneys, is commonly detected on autopsies; yet on conventional diagnostic imaging renal lymphoma is significantly underestimated and underreported, in part due to its variable imaging appearance and overlapping features with other conditions. We present a spectrum of typical and atypical appearances of renal lymphoma using multimodality imaging, while reviewing the roles of imaging in the detection, diagnosis, staging, and surveillance of patients with lymphoma. We also illustrate a breadth of benign and malignant entities with similar imaging features confounding the diagnosis of renal lymphoma, emphasizing the role of percutaneous image-guided biopsy. Understanding the spectrum of appearances of renal lymphoma and recognizing the overlapping entities will help radiologists improve diagnostic confidence and accuracy.
“…Although diffusion restriction is most commonly associated with solid lesions, it can also occur with acute, subacute or chronic infection. A renal abscess could simulate a solid renal mass on DWI/ADC due to marked diffusion restriction owing to the viscous fluid containing bacteria, mucoid proteins and cellular debris . Infection can however be potentially differentiated from tumour in that there is a discrepancy between the amount of diffusion restriction and the lesser amount of enhancement that is seen on the post‐contrast sequences, as illustrated in the case described above.…”
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