MRI Protocol for RENAL MASS

MRI  examinations are performed with dedicated body (array) coils  

Plain sequeces

• T1-weighted gradient-echo (GRE, in- and opposed-phase) AXIAL
• T2-weighted turbo spin echo (TSE) AXIAL & CORONAL
• 3D Spoiled Gradient echo-CORONAL-2mm(For renal arteries)
• Ultra fast GE axial

Post contrast Sequences

• DYNAMIC GADOLINIUM 3D Spoiled Gradient echo-CORONAL
• Ultra fast GE AXIAL-late arterial (20-s delay), nephrographic (80-s delay) and excretory phases (180-s delay).
• Normal Delayed- Ultra fast Gradient AXIAL/CORONAL-7 to 10 min
• Urogram Delayed- 3D Spoiled gradient echo AXIAL/CORONAL-7 to 10 min / thick-slab single-shot T2-weighted TSE

Follow up RENAL MASS
Plain MRI

• Ultra Fast SE non fat sat AXIAL & CORONAL
• Ultra Fast GE AXIAL

POST CONTRAST

• DYNAMIC GADOLINIUM 3D Spoiled Gradient echo-CORONAL
• Ultra fast GE AXIAL-late arterial (20-s delay), nephrographic (80-s delay) and excretory phases (180-s delay).

OPTIONAL 

The use of furosemide for forced diuresis and a further distension of the collecting system and for a consecutive reduction in the T2* effects of the concentrated contrast material is optional 

Concerning diffusion-weighted imaging (DWI), different authors have shown the value of apparent diffusion coefficients (ADCs) for characterising renal masses. 

NOTE:If the mass is near the hilum / collecting system give LASIX prior to the CONTRAST injuction.Dose: 1mg (1cc from standard 10cc vial)

               

The use of furosemide for forced diuresis and a further distension of the collecting system and for a consecutive reduction in the T2* effects of the concentrated contrast material is optional 

Concerning diffusion-weighted imaging (DWI), different authors have shown the value of apparent diffusion coefficients (ADCs) for characterising renal masses. 

In these studies, renal tumours had significantly lower ADCs compared with benign cysts, and solid enhancing tumours had significantly lower ADCs compared with non-enhancing necrotic or cystic regions]. They concluded that ADC measurements may aid in differentiating subgroups of renal masses, particularly benign cystic lesions from cystic renal cell cancers .