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Chapter 4 - Kidneys

from Section 2 - Abdomen

Published online by Cambridge University Press:  05 November 2012

David J. Grand ,
Courtney A. Woodfield  and
William W. Mayo-Smith
David J. Grand
Affiliation:
Brown University, Rhode Island Hospital
Courtney A. Woodfield
Affiliation:
Brown University, Rhode Island Hospital
William W. Mayo-Smith
Affiliation:
Brown University, Rhode Island Hospital
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Summary

Renal mass protocol

Indications

This protocol is used for evaluation of renal mass(es)/lesion(s), polycystic kidney disease, and hematuria.

Preparation

  • IV contrast agent: 1 mmol/kg gadopentetate dimeglumine at 2 cc/s

  • Oral contrast agent: None

  • 2 L nasal oxygen

  • At least 24-gauge IV; connect to power injector

  • Subtract volume-interpolated gradient echo pre from each dynamic post volume-interpolated gradient echo post sequence.

Exam sequences

  1. (1) Diffusion weighted imaging b50, 500/ADC – Very sensitive for lesion detection.

  2. (2) Coronal T2 single-shot fast-spin echo FS BH – Identify T2-bright lesions and septations/nodularity within them.

  3. (3) Axial single-shot fast-spin echo T2 non FS BH – Identify T2-bright lesions and septations/nodularity within them.

  4. (4–5) Axial in- and out-of-phase BH (IP/OOP) – Evaluate masses for microscopic fat.

  5. (6) Axial volume-interpolated gradient echo pre – Identify foci of T1-bright signal before contrast administration. Also assess for macroscopic fat via comparison to in-/out-of-phase images.

  6. (7) Coronal volume-interpolated gradient echo pre – Identify foci of T1-bright signal before contrast administration.

  7. (8) Coronal volume-interpolated gradient echo post at 30 seconds, 1 minute, and 2 minutes – Assess for enhancement.

  8. (9) Axial volume-interpolated gradient echo at 3 minutes – Assess for enhancement.

Type
Chapter
Information
Practical Body MRI
Protocols, Applications and Image Interpretation
 , pp. 49 - 57
Publisher: Cambridge University Press
Print publication year: 2012

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References

Israel, GMBosniak, MA.MRI of cystic renal massesMagn Reson Imaging Clin N Am 2004 12 403CrossRefGoogle ScholarPubMed
Kreft, BPMiny-Muller, HSommer, TDiagnostic value of MRI in comparison to CT in the detection and differential diagnosis of renal masses: ROC analysisEur Radiol 1997 7 542CrossRefGoogle Scholar
Leyendecker, JRClingan, MJ.Magnetic resonance urography update: are we there yet?Semin Ultrasound CT MR 2009 30 246CrossRefGoogle ScholarPubMed
Silverman, SGMortele, KGTuncali, KHyperattenuating renal masses: etiologies, pathogenesis, and imaging evaluationRadiographics 2007 27 1131CrossRefGoogle ScholarPubMed

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