Estudo comparativo dos métodos de ultra-sonografia, tomografia computadorizada e ressonância magnética no estadiamento e invasão das estruturas adjacentes por tumores renais.

• Main Author: Ribeiro, S. M.
• Publication Date: 2001
• Other Authors: Ajzen, S. A., Trindade, J. C.
• Format: Article
• Language: por
• Source: Repositório Institucional da UNESP
• Download full: http://dx.doi.org/10.1590/S0104-42302001000300031; http://hdl.handle.net/11449/66541
• topic: adult; aged; cancer invasion; cancer staging; comparative study; diagnostic imaging; echography; female; human; kidney tumor; male; methodology; nuclear magnetic resonance imaging; pathology; prospective study; sensitivity and specificity; tomography; Adult; Aged; Aged, 80 and over; Comparative Study; Diagnostic Imaging; English Abstract; Female; Human; Kidney Neoplasms; Magnetic Resonance Imaging; Male; Middle Age; Neoplasm Invasiveness; Neoplasm Staging; Prospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed

BACKGROUND: Ultrasonography (US), Computed Tomography (CT), and Magnetic Resonance imaging (MR) were compared for the staging of renal tumors. The differences between these imaging techniques were also studied for their ability to detect adenopathies, vascular invasion, distant intra-abdominal metastases, and particularly adjacent organ invasion. METHODS: Thirty-one patients with solid or complex renal masses were prospectively studied using US, CT, and MR. Differences between the results obtained were studied using the COCHRAN G test and the McNEMAR test. The sensitivity and specificity of each diagnostic technique were compared against a gold standard of the surgical and histopathological findings. RESULTS: The following sensitivities were obtained: For the detection of adenopathy, US 63.6%, CT and MR 90.9%. For vascular invasion, US 42.8%, CT and MR 85.7%. For the adjacent organ invasion, US 28.5%, CT 85.7%, and MR 71.4%. Some of the criteria that suggest invasion of adjacent structures include: the envelopment of the adjacent structures by the tumor, tumor extension into the adjacent structures with an irregular appearance, and alterations in shape, size, and density of adjacent structures. Loss of fat planes between the tumor and adjacent structures is not a sign of tumor invasion. CONCLUSIONS: Significant differences were found in the detection capacity of US in relation to CT and MR, which were similar. All three techniques were highly sensitive and specific only in the detection of distant abdominal metastases. In addition to the accuracy of these diagnostic modalities for the detection and staging of tumors, invasiveness, risks and cost should be considered in relation to relative costs and benefits.