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Eur Radiol. 2012 Feb;22(2):484-92. doi: 10.1007/s00330-011-2250-z. Epub 2011 Aug 30.

Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience.

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  • 1Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. ipedrosa@bidmc.harvard.edu

Abstract

OBJECTIVES:

To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function.

METHODS:

Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value <0.05 was considered statistically significant.

RESULTS:

Seventeen renal lesions were evaluated in 11 patients (8 male; mean age = 70 years) (range 57-86). The median eGFR was 24 mL/min/1.73 m(2) (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7).

CONCLUSIONS:

ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation.

KEY POINTS:

Arterial spin labeling may help to characterise renal masses in patients with renal failure Detection of blood flow on ASL in a renal mass supports the presence of a neoplasm Renal masses with high blood-flow levels on ASL seem to progress rapidly.

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PMID:
21877173
[PubMed - indexed for MEDLINE]
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