Role of Computed Tomography in the Evaluation of Renal Masses

Abstract

BACKGROUNDIn recent years, Computed Tomography (CT) has been found to be extremely useful in the diagnosis and treatment of renal masses. It provides an accurate morphologic picture of the renal mass. The precise contrast resolution makes identification of the characteristic attenuation values possible. Aims and Objectives -To characterise benign vs. malignant renal lesions based on CECT image analysis and to stage wherever possible. MATERIALS AND METHODS60 patients with suspected renal mass underwent CECT in Gauhati Medical College for a period from June 2014 to August 2015; patients who were diagnosed to have renal mass on ultrasound and referred for a CT scan for further evaluation. The images were analysed in unenhanced, corticomedullary, nephrographic and excretory phases after administration of non-ionic intravenous contrast. The lesion detection, enhancement pattern, local invasion and distant metastasis were assessed in pre-and post-contrast studies. RESULTSThere were 45 malignant and 15 benign lesions in our study; the radiological diagnoses of malignant mass was confirmed by histopathology, whereas benign lesions were followed up to confirm their benignity. We had two false positive cases in our study, one was an oncocytoma and another was an angiomyolipoma. MDCT was 100% sensitive, 88.2% specificity and reached an accuracy rate of 96.7%. CONCLUSIONAs a result of the study, the following conclusions can be stated: CT has excellent accuracy in the diagnosis, characterisation and differentiating benign and malignant renal masses and for the characterisation of small renal mass the degree of enhancement on the corticomedullary phase is the most valuable parameter.