Campbell Naomi, Rosenkrantz Andrew B, Pedrosa Ivan
From the *Department of Radiology, Center for Biomedical Imaging, NYU Langone Medical Center, New York, NY; and †Department of Radiology and ‡Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX.
Top Magn Reson Imaging. 2014 Apr;23(2):95-115. doi: 10.1097/RMR.0000000000000019.
Renal cell carcinoma (RCC) is most commonly diagnosed as an incidental finding on cross-sectional imaging and represents a significant clinical challenge. Although most patients have a surgically curable lesion at the time of diagnosis, the variability in the biologic behavior of the different histologic subtypes and tumor grade of RCC, together with the increasing array of management options, creates uncertainty for the optimal clinical approach to individual patients. State-of-the-art magnetic resonance imaging (MRI) provides a comprehensive assessment of renal lesions that includes multiple forms of tissue contrast as well as functional parameters, which in turn provides information that helps to address this dilemma. In this article, we review this evolving and increasingly comprehensive role of MRI in the detection, characterization, perioperative evaluation, and assessment of the treatment response of renal neoplasms. We emphasize the ability of the imaging "phenotype" of renal masses on MRI to help predict the histologic subtype, grade, and clinical behavior of RCC.
肾细胞癌（RCC）最常作为横断面成像时的偶然发现而被诊断出来，是一项重大的临床挑战。尽管大多数患者在诊断时存在可通过手术治愈的病变，但RCC不同组织学亚型和肿瘤分级的生物学行为存在差异，再加上管理选择越来越多，这给针对个体患者的最佳临床方法带来了不确定性。先进的磁共振成像（MRI）可对肾脏病变进行全面评估，包括多种形式的组织对比度以及功能参数，进而提供有助于解决这一困境的信息。在本文中，我们回顾了MRI在肾肿瘤的检测、特征描述、围手术期评估和治疗反应评估中不断发展且日益全面的作用。我们强调MRI上肾肿块的成像“表型”有助于预测RCC的组织学亚型、分级和临床行为的能力。
