The Computed Tomography in Differentiation of Renal Angiomyolipoma from Renal Cell Carcinoma

Abstract

Background: The most common Imaging modality used now a day to diagnose and to differentiate between renal angiomyolipoma and renal cell carcinoma are the Ultrasonography , Computerized Tomography scanning and Magnetic Resonance Imaging . Ultrasound is commonly employed as an initial imaging exam due to its relative low cost, relative ease of performance, and lack of need for ionizing radiation. Objective: To evaluate the Role of Ultrasound (gray scale and color Doppler) in differentiating renal angiomyolipoma from Renal Cell Carcinoma in comparison to Computerized Tomography scanning finding. Patients and Methods: This study was conducted in the Radiology department / Alsader teaching hospital / Basrah / Iraq during the period from ( January 2016 ) to (January 2017 ) , (48 ) patients with suspicion of renal angiomyolipoma were referred for CT scan examination for definite diagnosis , all these patients were re-examined by Gray Scale and Color Doppler Utrasound to confirm the presence of renal mass and to determine its benign or malignant features. The data was analyzed using SPSS version 20. Results: Of the 47 hyperechoic renal masses; 44(93.61%) were diagnosed as Renal angiomyolipoma on CT scan and 3(6.38%) were diagnosed as Renal Cell Carcinoma . Of the 3 isoechoic renal masses; 1(33.33%) were diagnosed as Renal angiomyolipoma and 2 (66.66%) as Renal Cell Carcinoma. all the 20 renal masses that contain shadowing on Ultrasound examination were hyperechoic and were diagnosed as renal angiomyolipoma on CT scan. All 3 renal masses that contain hypoechoic rim on Ultrasound examination were hyperechoic and were diagnosed as Renal Cell Carcinoma on CT scan examination. The 2 masses that contain intramural cyst; one of them was hyperechoic and the other was isoechoic and both of them diagnosed as Renal Cell Carcinoma. Of the 14 renal masses that contain exophytic sign; 10 of them were diagnosed as Renal angiomyolipoma (9 of them hyperechoic) and 4 were diagnosed as Renal Cell Carcinoma (2 of them were Isoechoic). all the 6 renal masses with peripheral pattern of vascularity were diagnosed as renal angiomyolipoma on CT scan ( 5 of them were hyperechoic on ultrasound ), on other hand all the 5 renal masses with diffuse pattern of vascularity were diagnosed as Renal Cell Carcinoma on CT scan (3 of them were hyperechoic on ultrasound)