We have located links that may give you full text access.
Using helical CT to evaluate renal cell carcinoma in patients undergoing hemodialysis: value of early enhanced images.
AJR. American Journal of Roentgenology 1999 Februrary
OBJECTIVE: The purpose of this study was to evaluate early and delayed enhanced helical CT for revealing renal cell carcinoma in patients undergoing hemodialysis.
MATERIALS AND METHODS: Over the course of 3 years, 630 chronic hemodialysis patients underwent early and delayed contrast-enhanced and unenhanced helical CT to detect renal cell carcinoma. Retrospective review showed that 23 of these patients later underwent either unilateral or bilateral nephrectomy. Two radiologists, unaware of the pathology results, independently reviewed these 23 examinations. The sensitivity and specificity of each early and delayed scan for revealing neoplasms were determined using pathology as the gold standard. The mean attenuation values of the neoplasms and parenchymas of end-stage kidneys on both early and delayed enhanced images were also compared.
RESULTS: Helical CT revealed 225 lesions, 24 of which were found to be renal cell carcinomas at pathology. Delayed enhanced helical CT failed to detect one papillary carcinoma in an end-stage kidney with acquired cysts. Three nonpapillary carcinomas were not detected on delayed scans, and one was missed on an early scan of a patient without acquired cysts. The sensitivity and specificity of early enhanced CT for revealing renal cell carcinoma were 96% and 95%, respectively. In contrast, delayed enhanced CT achieved a sensitivity of 83% and a specificity of 94%. A significant difference in mean attenuation values between carcinomas and renal parenchymas was observed on the images with early enhancement but not on those with delayed enhancement (p < .0001).
CONCLUSION: Early enhanced helical CT is superior to delayed enhanced helical CT for revealing renal cell carcinoma in end-stage kidneys.
MATERIALS AND METHODS: Over the course of 3 years, 630 chronic hemodialysis patients underwent early and delayed contrast-enhanced and unenhanced helical CT to detect renal cell carcinoma. Retrospective review showed that 23 of these patients later underwent either unilateral or bilateral nephrectomy. Two radiologists, unaware of the pathology results, independently reviewed these 23 examinations. The sensitivity and specificity of each early and delayed scan for revealing neoplasms were determined using pathology as the gold standard. The mean attenuation values of the neoplasms and parenchymas of end-stage kidneys on both early and delayed enhanced images were also compared.
RESULTS: Helical CT revealed 225 lesions, 24 of which were found to be renal cell carcinomas at pathology. Delayed enhanced helical CT failed to detect one papillary carcinoma in an end-stage kidney with acquired cysts. Three nonpapillary carcinomas were not detected on delayed scans, and one was missed on an early scan of a patient without acquired cysts. The sensitivity and specificity of early enhanced CT for revealing renal cell carcinoma were 96% and 95%, respectively. In contrast, delayed enhanced CT achieved a sensitivity of 83% and a specificity of 94%. A significant difference in mean attenuation values between carcinomas and renal parenchymas was observed on the images with early enhancement but not on those with delayed enhancement (p < .0001).
CONCLUSION: Early enhanced helical CT is superior to delayed enhanced helical CT for revealing renal cell carcinoma in end-stage kidneys.
Full text links
Related Resources
Trending Papers
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app