Hélénon O, Denys A, Chrétien Y, Souissi M, Melki P, Cornud F, Dufour B, Moreau J F
Service de Radiologie, Hôpital Necker, Paris.
J Radiol. 1993 Feb;74(2):105-15.
The recent technical developments in magnetic resonance imaging (MRI) and the use of paramagnetic contrast media (gadolinium compounds) have considerably improved the performances of MRI for the detection and characterization of renal tumors. MRI does not have specific merits for the diagnosis of the typical form of cancer, nor for the detection of small kidney tumors, both being mainly based on computed tomography (CT). On the other hand, it can be used for the diagnosis of atypical forms of cancers (small, hypovascular, cystic or hemorrhagic cancers) which raise problems of differential diagnosis with some pseudotumoral lesions, complex cysts and benign tumors. Its complementarity to CT for the characterization of an atypical mass results from the signal information it provides, from a better contrast resolution, and from the possibility to make sections in all planes of space. Except for angiomyolipoma, which has a fatty content, there is no really specific MR criterion as present to evidence benign renal tumors. Concerning regional extension, CT remains the primary technique of choice, as it allows studying the limits of the tumor, the renal compartment ans its walls, the renal vein and the inferior vena cava, the neighboring organs and the contralateral kidney all together. Its findings allow defining the indications of MRI, which, as a complementary exploration, is often decisive to assess venous invasion.
磁共振成像（MRI）的最新技术进展以及顺磁性造影剂（钆化合物）的使用，极大地提高了MRI在检测和表征肾肿瘤方面的性能。MRI对于典型癌症形式的诊断以及小肾肿瘤的检测并没有特定优势，这两者主要基于计算机断层扫描（CT）。另一方面，它可用于诊断非典型癌症形式（小的、血供少的、囊性或出血性癌症），这些癌症在与一些假瘤性病变、复杂囊肿和良性肿瘤进行鉴别诊断时会产生问题。它与CT在表征非典型肿块方面的互补性源于其提供的信号信息、更好的对比分辨率以及在空间所有平面进行切片的可能性。除了含有脂肪成分的血管平滑肌脂肪瘤外，目前没有真正特异性的MR标准来证实良性肾肿瘤。关于局部扩展，CT仍然是首选的主要技术，因为它可以一起研究肿瘤的边界、肾实质及其包膜、肾静脉和下腔静脉、邻近器官以及对侧肾脏。其检查结果有助于确定MRI的适应证，而MRI作为一种补充检查，对于评估静脉侵犯往往具有决定性作用。
