JOURNAL ARTICLE

Angiomyolipoma with minimal fat: differentiation from papillary renal cell carcinoma by helical CT

Y-Y Zhang, S Luo, Y Liu, R-T Xu
Clinical Radiology 2013, 68 (4): 365-70
23321146

AIM: To evaluate whether helical computed tomography (CT) images can be used to differentiate angiomyolipomas (AMLs) with minimal fat from papillary renal cell carcinomas (PRCCs) based on their morphological characteristics and enhancement features.

MATERIALS AND METHODS: This retrospective study was approved by the institutional review board. Informed consent was waived. Forty-four patients (21 with AMLs with minimal fat and 23 with PRCCs) who underwent enhanced helical CT before total or partial nephrectomy were included. Two radiologists, who were blinded to the histopathology results, read the CT images and recorded the attenuation value, morphological characteristics, and enhancement features of the tumours, which were subsequently evaluated. An independent samples t-test, χ(2) test, and rank sum test were performed between the tumours. The predictive value of a CT finding was determined by multivariate logistic regression analysis.

RESULTS: AML with minimal fat had an apparent female prevalence (p < 0.01). Intra-tumoural vessels were noted in 11 cases of AML with minimal fat and three PRCC cases (p < 0.01). The unenhanced attenuation characteristic was significantly different between the two diseases (p < 0.001). The absolute attenuation values (AAVs) and the corrected attenuation values (CAVs) of the AML with minimal fat group of unenhanced and two phases of enhanced images were greater compared with that of the PRCC group (p < 0.05). After contrast medium injection, the tumour enhancement value (TEV) of the AML with minimal fat group in the corticomedullary phase was greater than that of the PRCC group (p < 0.01). Most cases of both tumour types demonstrated early enhancement characteristics; the enhancement value of the AML with minimal fat group was greater compared with that of the PRCC group (p < 0.01). The unenhanced attenuation characteristic, intra-tumoural vessels, and CAVs of unenhanced and early excretory phase scans were valuable parameters to differentiate between AML with minimal fat and PRCC tumours by multivariate logistic regression analysis (p < 0.05 for all).

CONCLUSION: The unenhanced attenuation characteristic, intra-tumoural vessels, and the attenuation values of unenhanced and early excretory phase scans are valuable parameters in differentiating AML with minimal fat from PRCC at CT.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23321146
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"