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摘要
To evaluate previously described growth patterns in < 4 cm solid renal masses.
With IRB approval, 63 renal cell carcinomas (RCC; clear cell n = 22, papillary n = 28, chromophobe n = 13) and 36 benign masses [minimal-fat (mf) angiomyolipoma (AML) n = 13, oncocytoma n = 23) from a single institution were independently evaluated by two blinded radiologists (R1/R2) using T2-weighted MRI for (1) the angular interface sign (AIS), (2) bubble-over sign (BOS), (3) percentage (%) exophytic growth and (4) long-to-short axis ratio. Comparisons were performed using ANOVA, chi-square and multi-variate regression.
AIS was present in 11.1% (7/63) -9.5% (6/63) R1/R2 RCC compared to 13.9% (5/36) -19.4% (7/36) R1/R2 benign masses (p = 0.68 and 0.16). BOS was present in 11.1% (7/63) -3.2% (2/63) R1/R2 RCC compared to 16.7% (6/36) -8.3% (3/36) R1/R2 benign masses (p = 0.432 and 0.261). Agreement was moderate (K = 0.50 and 0.55). mf-AML [66 +/- 32% (range 0-100%)] and oncocytoma [53 +/- 26% (0-90%)] had larger % exophytic growth compared to RCC [32 +/- 23% (0-80%)] (p < 0.001). No RCC had 90-100% exophytic growth, present in 38.5% (5/13) mf-AMLs and 17.4% (4/23) oncocytomas. The long-to-short axis did not differ between groups (p = 0.053).
Benign masses show greater % exophytic growth whereas other growth patterns are not useful. Future studies evaluating % exophytic growth using multi-variate MR analysis in renal masses are required.
aEuro cent Greater exophytic growth is associated with benignity among solid renal masses.
aEuro cent Only minimal fat AMLs and oncocytomas had 90-100% exophytic growth.
aEuro cent The angular interface sign was not useful to differentiate benign masses from RCC.
aEuro cent The bubble-over sign was not useful to differentiate benign masses from RCC.
aEuro cent Subjective analysis of growth patterns had fair-to-moderate agreement.
- 出版日期2018-8
