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Diffusion-weighted MRI in the evaluation of renal lesions: preliminary results

¹ Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste and ² Department of Diagnostic and Interventional Radiology, University of Roma "Tor Vergata", Viale Oxford 81, 00133 Roma, Italy

View larger version (11K): [in a new window]   Figure 1. Plot shows apparent diffusion coefficient (ADC) values for the normal renal parenchyma (), cysts (), hydronephrosis (), pyonephrosis (), and solid renal tumours ().

View larger version (76K): [in a new window]   Figure 2. Normal kidneys in a 48-year-old woman. (a) Diffusion-weighted SE EPI image with b=0 s mm–2. (b) Diffusion-weighted SE EPI image with b=500 s mm–2. (c) Apparent diffusion coefficient (ADC) map. The ADC value measured in the region of interest (ROI) located in the anterior labrum of the right kidney is 1.91±0.31 x 10–3 mm2 s–1.

View larger version (119K): [in a new window]   Figure 3. Cyst of the right kidney. (a) Axial turbo spin echo (TSE) T2 weighted image with fat saturation. The lesion is clearly hyperintense. (b) Diffusion-weighted spin-echo echo planar imaging (SE EPI) image with b=0 s mm–2. The cyst is highly hyperintense. (c) Diffusion-weighted SE EPI image with b=500 s mm–2. The cyst is slightly hyperintense. (d) Apparent diffusion coefficient (ADC) map. The ADC value measured at the cyst level is 3.48±0.16 x 10–3 mm2 s–1, while the ADC value measured in the renal parenchyma is 2.16±0.19 x 10–3 mm2 s–1.

View larger version (133K): [in a new window]   Figure 4. Hydronephrosis of the right kidney and pyonephrosis of the left kidney. (a) Coronal turbo spin echo (TSE) T1 weighted image. Low signal intensity of the dilated right and left collecting systems. (b) Diffusion-weighted spin-echo echo planar imaging (SE EPI) image with b=0 s mm–2. Slight hyperintensity of the renal pelvis of right and left kidney. (c) Diffusion-weighted SE EPI image with b=500 s mm–2. Very low signal intensity of the right renal pelvis. Marked hyperintensity of the renal pelvis of the left kidney, indicative of restricted diffusion. (d) Apparent diffusion coefficient (ADC) map. The ADC value measured at the right dilated hydronephrotic renal pelvis is 3.39±0.48 x 10–3 mm2 s–1, while the ADC value measured at the left dilated renal pyonephrotic pelvis is 0.77±0.17 x 10–3 mm2 s–1.

View larger version (106K): [in a new window]   Figure 5. Oncocytoma of the right kidney. (a) Axial turbo spin echo (TSE) T2 weighted image with fat saturation. The lesion is clearly hypointense. (b) Diffusion-weighted spin-echo echo planar imaging (SE EPI) image with b=0 s mm–2. The lesion is slightly hypointense. (c) Diffusion-weighted SE EPI image with b=500 s mm–2. The lesion is homogeneous and clearly hyperintense. This feature is indicative of restricted diffusion. (d) Apparent diffusion coefficient (ADC) map. The ADC value measured in the oncocytoma is 1.33±0.12 x 10–3 mm2 s–1. (e) ADC map at the same level 1 week later. The ADC value measured in the oncocytoma is 1.38±0.21 x 10–3 mm2 s–1, showing the reproducibility of the technique.