Characterization of Small Renal Masses Less than 4 cm with Quadriphasic Multidetector Helical Computed Tomography: Differentiation of Benign and Malignant Lesions
최승권, 전승현, 장성구,
소속 상세정보
최승권 ( Choi Seung-Kwon )
Kyung Hee University School of Medicine Department of Urology
전승현 ( Jeon Seung-Hyun )
Kyung Hee University School of Medicine Department of Urology
장성구 ( Chang Sung-Goo )
Kyung Hee University School of Medicine Department of Urology
KMID : 0358320120530030159
Abstract
Purpose: To identify the characteristic quadriphasic (unenhanced, corticomedullary, nephrographic, and excretory phase) helical multidetector computed tomography (MDCT) features of renal masses less than 4 cm to distinguish benign from malignant renal masses.
Materials and Methods: In total, 84 patients were retrospectively analyzed to determine the characteristic features for the prediction of subtypes of small renal masses. The patients’ age, gender, and tumor size and CT features, including the presence of intra-tumor degenerative changes, septation, calcification, and wall irregularity, were evaluated. In addition, the degree and pattern of enhancement obtained during four phases were analyzed. The relationship between the subtype of the small renal masses and the gender, morphological features, and pattern of contrast enhancement on the CT was analyzed by using the chi-square test. Tumor size and degree of contrast enhancement were compared by the Mann-Whitney U test. The predictive value of each of the CT features was determined by multivariate logistic regression analysis.
Results: Of the 84 small renal masses, 17 (20%) were benign and 67 (80%) were malignant. Univariate analysis revealed that renal cell carcinoma lesions showed heterogeneous enhancement (p=0.002) and higher mean attenuation value on the corticomedullary and nephrographic phases (135.1±53.9, p=0.000, and 132.4±43.6, p=0.006). The multivariate analysis with logistic regression model showed that only the mean attenuation value on the corticomedullary phase had a statistically significant correlation (p=0.021).
Conclusions: For the characterization of small renal masses, the degree of enhancement on the corticomedullary phase is a valuable parameter. Furthermore, the heterogeneous enhancement pattern and degree of enhancement on the nephrographic phase can provide information for differentiating small renal masses.
키워드
Benign neoplasm; Computed tomography; Renal cell carcinoma
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