Dynamic MRI of small renal cell carcinoma.

Objective: To evaluate the appearance of contrast-enhanced dynamic MRI of small renal cell carcinoma (RCC) (<3 cm diameter). Materials and Methods: Twenty-seven patients with 28 small RCCs were studied by both conventional spin echo and contrast-enhanced dynamic MRI for tumor detection and characterization. All tumors were detected by contrast-enhanced CT and confirmed by operation. Dynamic MRI was performed using a breath-herd fast low angle shot technique after rapid injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). Characterization of a renal mass was done by the visual analysis of tumor vascularity as well as quantitative assessment of the contrast noise ratio (CNR) and degree of enhancement. Results: With conventional spin echo MR and dynamic MR, 18 and 26 of 28 small RCCs were detected, respectively. In the dynamic study the tumor/renal medulla contrast was marked at 90-120 s after administration of Gd-DTPA (CNR:15.1). The tumor/renal medulla contrast in the dynamic study was more marked than that of postcontrast T1-weighted imaging (CNR, -0.25); T2-weighted imaging (CNR, 3.1); and T1-weighted imaging (CNR, -0.76). Conclusion: Contrast-enhanced dynamic MRI is a useful technique for the diagnosis of small RCC especially in a patient with renal insufficiency or allergy to iodinated contrast material.