Role Of Multi-Slice CT In The Evaluation Of Solid Renal Masses

Renal cell carcinoma represents 1–3% of all visceral neoplasms however, accounting for 85–90% of all solid renal tumors in adults. The classification of renal cell carcinoma into subtypes has become of interest because of the association with prognosis, where some types with poor prognosis and others have a more favorable prognosis.Objectives: The aim of this work is to detect the role of MSCT in the evaluation of solid renal masses and see is it possible to differentiate between the benign and malignant lesions and is it possible to differentiate between the different subtypes of renal cell carcinoma.Patients and Methods: This work was conducted from October 2010 to August 2011 on 30 patients (21 males and 9 females). Their age ranged from 40 to 70 years with a mean age  the standard deviation of 59.68.01 years. They were consecutively referred to Diagnostic Radiology Department, Zagazig University Hospitals and private centers. All patients have renal masses in routine US examination.Results: The malignant lesions were 27 cases (12 case of clear type, 6 cases of chromophobe type,6 cases of papillary type and 3 cases of lymphoma) while the benign lesions were 3 cases of AML).The final diagnosis was confirmed by histopathological examinations in all cases. We compared MSCT findings with post-operative and pathology results; we found that MSCT achieves 100% accuracy in detection and localization of the lesions. As regard the assessment of renal vascular anatomy MSCT had 100% accuracy in detection of number and course of renal arteries & veins.Conclusion: US with Doppler used as a screening modality for detection of solid renal masses. Conventional CT is no longer used in renal masses assessment. MDCT is valuable modality in differentiation between the subtypes of RCC by using the degree of enhancement which is the most valuable parameter in differentiation among these subtypes. MRI is preserved in evaluation of renal masses in cases with hypersensitivity to contrast, renal impairment or any other contraindication to ionizing radiation.