Magnetresonanztomographische Identifizierung und Charakterisierung renaler Raumforderungen mit GE-Sequenzen unter Applikation von Gd-DTPA

Würstlin, S; Ip, Arlart; Guhl, L.; Nagler-Reus, N; Rr, Edelman

doi:10.1055/s-2008-1032694

Cited by 4 publications

(5 citation statements)

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“…This result is in accordance with previous studies where the values for a correct characterization of renal masses ranged without statistical differences between CT and MRI from 91 to 99 % [10,11]. In our study correct characterization of a lesion as malignant was also slighly higher on MRI (86.8 %) as compared with CT (78.3 %), but there was no statistical difference.…”

Section: Discussionsupporting

confidence: 93%

“…Although recently there has been a report about the variability of density measurements of cysts on CT proposing a threshold of at least 15 HU for contrast enhancement [23], the former is almost universally accepted. It is not suprising that MRI of renal masses did not perform very much better in lesion characterization than CT in studies because they were mostly based on the results of the T1-weighted sequences [10,11]. The marginal better results of MRI might be caused by the better contrast resolution of MRI as compared with CT or by different imaging time points after contrast administration, so that a small, early, or late enhancement of a mass can be better detected.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging of the kidneys has not played an important role in the past decade with regard to renal lesions, although some studies recently showed MRI to be helpful in the detection and staging of renal cancer [5][6][7][8][9][10][11][12][13][14]. However, the role of MRI and the indication of MRI in the workup of renal lesions has not clearly been established [2].…”

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confidence: 99%

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Diagnostic value of MR imaging in comparison to CT in the detection and differential diagnosis of renal masses: ROC analysis

et al. 1997

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The aim of this work was to compare MR imaging and CT in the detection of renal masses and in the differential diagnosis between benign and malignant lesions. In 33 patients with 54 renal lesions CT and MR images were evaluated by four readers with regard to tumor detection and characterization using a receiver-operating-characteristics (ROC) analysis. The MRI protocol consisted of a T1-weighted spin-echo (SE) sequence (TR/TE: 300/10 ms) before and after contrast administration and a heavily T2-weighted turbo-SE (TSE) sequence (TR/TE: 5500/150 ms). Az values for the area under the ROC curves for lesion detection were 0.92 +/- 0.04 for CT and 0.91 +/- 0.05 for MRI, respectively, which was not statistically different. The MRI technique was slightly, but not significantly, better than CT in the overall characterization (accuracy in differentiation between benign and malignant) of renal lesions with an Az value of 0.90 +/- 0.05 compared with 0.88 +/- 0.06 for CT. The MRI technique proved to be statistically superior to CT (p < 0.01) in the correct characterization of benign renal lesions. MRI equals CT in the overall detection and differential diagnosis of renal masses. MRI is very helpful for further differential diagnosis of lesions which are equivocal on CT especially in the differentiation between complicated cysts and cystic or hypovascular renal cell carcinoma.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic value of MR imaging in comparison to CT in the detection and differential diagnosis of renal masses: ROC analysis

et al. 1997

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“…In previous studies gradient-echo sequences were applied routinely to image renal lesions in breath-hold mode [12,13,14]. In one study the combination of fat saturation and contrast enhancement was described to offer the highest diagnostic accuracy [3].…”

Section: Discussionmentioning

confidence: 99%

Fast sequences with fat suppression in breath-hold mode: new standard in contrast-enhanced T1-weighted MR imaging of renal tumors?

et al. 2001

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Our purpose was to analyze detection, diagnostic characterization, and staging of renal solid lesions using different fast T1-weighted sequences with fat suppression in breath-hold mode compared with a gradient-echo sequence after contrast application. Twenty-five patients with focal renal lesions were examined with a T1-weighted ultrafast turbo spin-echo (UTSE) sequence with frequency selective fat suppression (SPIR), two different segmented echo-planar imaging (EPI) sequences - a spin-echo and a gradient-echo echo-planar sequence (SE-, FFE-EPI) combined with SPIR and a gradient-echo (fast field echo, FFE) sequence in a prospective study. The images of all sequences were visually evaluated and in addition to qualitative evaluation the contrast-to-noise ratio (CNR) for cyst and solid lesions was measured. Among the different T1-weighted sequences, the best detection and characterization of renal solid lesions were obtained with the UTSE SPIR and the SE-EPI sequence (sensitivity: 100 and 75%, respectively; specificity: 90 and 75%, respectively). The FFE and FFE-EPI sequences showed lower sensitivity (86%) and the same specificity (75%). The staging of renal tumors was best achieved with the UTSE SPIR and SE-EPI sequence (84 and 73%, respectively). The staging was correct in only 47% and 58 for the FFE and FFE-EPI sequences, respectively. The investigated sequences showed no significant differences in CNR. The combination of fat suppression and breath-hold mode improves detection, characterization, and staging of renal lesions. The UTSE SPIR and SE-EPI sequence in breath-hold mode showed specific image artifacts, but offered high sensitivity and specificity for detection and characterization of renal lesions compared with the FFE sequence. The results of this study suggest, for T1-weighted imaging of renal tumors, use of UTSE or SE-EPI sequences with fat suppression in breath-hold mode for renal imaging.

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“…The TSE sequence without respiratory control showed no improvement in image quality or in CNR, compared with the conventional SE sequence, and cannot be recommended for renal imaging. The standard sequence of T1 -weighted imaging without fat suppression is still the breath-hold gradient-echo sequence (25,26). Therefore, the optimal T1 weighted sequence has not yet been established.…”

Section: Imentioning

confidence: 99%

Fast and ultrafast magnetic resonance imaging in renal lesions

Walter

Jockenhöfer

Heindel

et al. 1998

Magnetic Resonance Imaging

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Our purpose was to analyze and compare the image quality and contrast-to-noise ratio (CNR) of different fast T1- and T2-weighted sequences with conventional spin-echo sequences in renal MRI. Twenty-three patients with focal renal lesions were examined with a T2-weighted ultrafast turbo spin-echo (UTSE) sequence with and without frequency selective fat suppression (SPIR), a combined gradient-and-spin-echo sequence (GraSE), and a conventional spin-echo sequence (SE). In addition, T1-weighted images were obtained pre- and postcontrast, using a fast spin-echo sequence (TSE) with and without SPIR and the conventional SE sequence. Among the T2-weighted images, the highest CNR and the best image quality were obtained with the UTSE sequence, followed by the fat-suppressed UTSE sequence. GraSE and conventional SE sequences showed a significantly lower CNR and image quality (p < 0.05). The T1-weighted sequences did not show significant differences, in either precontrast or postcontrast measurements. T2-weighted UTSE with and without fat suppression combined excellent image quality and high CNR for imaging and detection of renal lesions. The T1-weighted fast sequences provided no alternative to the gradient-echo or to the conventional SE sequences. The results of this systematic study suggest the use of T2-weighted fast techniques for improved diagnostic accuracy of renal MRI.

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Magnetresonanztomographische Identifizierung und Charakterisierung renaler Raumforderungen mit GE-Sequenzen unter Applikation von Gd-DTPA

Cited by 4 publications

References 0 publications

Diagnostic value of MR imaging in comparison to CT in the detection and differential diagnosis of renal masses: ROC analysis

Diagnostic value of MR imaging in comparison to CT in the detection and differential diagnosis of renal masses: ROC analysis

Fast sequences with fat suppression in breath-hold mode: new standard in contrast-enhanced T1-weighted MR imaging of renal tumors?

Fast and ultrafast magnetic resonance imaging in renal lesions

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