Renal masses: evaluation with gradient-echo Gd-DTPA-enhanced dynamic MR imaging

Dynamic contrast material-enhanced gradient-echo magnetic resonance (MR) imaging was performed on 15 patients with 18 renal masses (seven simple renal cysts, nine renal cell carcinomas, one angiomyolipoma, and one oncocytoma). Fifteen sequential images were obtained while the patients held their breath during a 2.5-3.5-minute interval during and immediately after the intravenous administration of gadolinium diethylenetriaminepentaacetic acid (DTPA); delayed images were also obtained for 15 minutes. Time-intensity curves showed that renal cortical enhancement reached maximal intensity 80 seconds after the injection of Gd-DTPA. Medullary enhancement reached maximal intensity at 120 seconds. None of the simple renal cysts showed enhancement; each cyst displayed a signal intensity less than that of the renal cortex on precontrast images. All renal cell carcinomas were isointense with the renal cortex and demonstrated variable enhancement. Three patterns of enhancement were observed: predominantly peripheral, heterogeneous, and homogeneous. Both the angiomyolipoma and the oncocytoma showed brisk, homogeneous enhancement. This MR imaging technique appears to be useful in the detection and characterization of simple renal cysts and solid neoplasms.