Medical Radiology and Radiation Safety. 2021. Vol. 66. № 6. P. 75–80
The Comparison of the Results of Ultrasound, CT and MRI in the Diagnosis
of Angiomyolipoma Kidneys, Including Complicated by Development
of the Syndrome Wunderlich
N.S. Vorotyntseva1, M.V. Gaidukova2
1Kursk State Medical University, Kursk, Russia.
2Clinic Expert Tver, Tver, Russia
Contact person: Natalia Sergeevna Vorotyntseva, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Purpose: Analysis the effectiveness of various methods of radiation studies for the detection of renal angiomyolipomas (RAMLs), including the diagnosis of Wunderlich syndrome.
Material and methods: The analysis of the results of a comprehensive radiation study of the kidneys of 115 patients who were diagnosed with focal formation in primary renal ultrasound was carried out. Further, of those 115 people, 47 patients underwent MRI of the kidneys, 60 patients – CT and 8 patients complex MRI+CT, including contrast-enhanced vasculature.
Results and discussion: Angiomyolipoma was detected by ultrasound in 38 (33.0 %) of 115 patients, and according to MRI and CT in total in 27 (23.5 %) patients. Coincidence of ultrasound findings and MRI and CT results was in 18 patients. Consequently, the sensitivity of ultrasound in the diagnosis of RAML was compared with MRI – 45 %; when compared with CT – 42.8 %, and specificity – 55 % and 57.1 %, respectively. Reliable signs of RAML in ultrasound were hyperechogenic homogeneous structure, clear smooth contours of the formation. The rounded form of education is statistically unreliable. Statistically significant characteristics of RAML in magnetic resonance imaging are heterogeneous structure, heterogeneous hyperintense MR-signal on T1 and heterogeneously hypointensity on T2-weighted images, always uniformly hypo-Fs for T1 / T2 Fs, with hypo clear boundary between education and renal parenchyma on T1 in the opp phase. Reliable signs of RAML with CT are non-uniform structure of education, with non-uniform x-ray density.
Conclusion: Ultrasound diagnosis is necessary for screening kidney disease, while CT and MRI have greater sensitivity and specificity to determine the nature of focal formation. With the development of Wunderlich’s syndrome, a complex of radiological methods, including ultrasound, MRI and CT, allows to diagnose the cause of hemorrhage, as well as to obtain complete diagnostic information necessary for the surgeon to plan treatment.
Keywords: benign tumors, CT, kidney, MRI, renal neoplasms, sonography, angiomyolipoma. Wunderlich’s syndrome
For citation: Vorotyntseva NS, Gaidukov MV. The Comparison of the Results of Ultrasound, CT and MRI in the Diagnosis of Angiomyolipoma Kidneys, Including Complicated by Development of the Syndrome Wunderlich. Medical Radiology and Radiation Safety. 2021;66(6):75–80.
DOI: 10.12737/1024-6177-2021-66-6-75-80
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 07.06.2021.
Accepted for publication: 20.09.2021.