DIFFERENTIATION OF SOLID RENAL TUMOURS WITH MULTIPARAMETRIC MR IMAGING WITH HISTOLOGICAL CORRELATION

Abstract

OBJECTIVES: To identify the radiologic ndings of the most common solid renal masses found in adult age group, illustrate imaging and histology correlates, and draw a clear diagnostic approach. 62 MATERIALS & METHODS: patients suspected to have solid renal masses were evaluated with mp-MRI. T2 SIR, ADC value and ADC ratio on DWI, SII on chemical shift imaging and wash in and wash out indices on dynamic contrast enhanced imaging were calculated for each tumor and the values were compared among different histologically proven renal tumors. ccRCC showed maximum T2 SIR wherea RESULTS: s pRCC and lp-AML showed lowest mean T2 SIR. There is signicant difference in SII of clear cell RCC (15.03±7.62) and non-clear cell renal cortical tumor (1.54±10.67), p<0.001. We found signicant difference in mean tumor ADC of benign vs malignant lesions (p <0.006), higher stage (III & IV) vs lower stage (stage I &II) p <0.001. We found signicant differences between clear cell and non-clear cell renal tumors in wash in indexes in all phases (p = 0.001) and late wash out index (p< 0.001). There is signicant difference of papillary RCCs and other renal tumors in arterial and parenchymal WiI (p<0.001), early WoI (p=0.018) as well as late WoI (p<0.001). There is also signicant difference between chromophobe RCCs and oncocytomas for arterial WiI (p=0.009), parenchymal and late WiI (p= 0.006); Multiparametric renal MRI is useful CONCLUSION: for differentiating solid renal tumors, predict their histologic grading and thus guide further management