RENAL-CELL CANCER - INCIDENCE OF HEMORRHAGE ON MR-IMAGES IN PATIENTS WITH CHRONIC RENAL-INSUFFICIENCY

This study describes the occurrence of hemorrhage in renal cancer in p atients with chronic renal insufficiency as shown on MR images. Thirte en consecutive patients with chronic renal insufficiency who had histo logically proven renal cancer and underwent MRI at 1.5 T were entered in the study. MR examinations included spoiled gradient echo (SGE) and T1-weighted fat-suppressed imaging pre- and postgadolinium administra tion, All renal cancers were well shown on MR images and were most cle arly depicted on postgadolinium T1-weighted fat-suppressed images. Tum ors in 12 of 13 patients had regions of high signal intensity on preco ntrast T1-weighted images. Histology demonstrated intratumoral hemorrh age in all 12 of these patients. Four hemorrhagic tumors were largely cystic on imaging studies, One of these cancers altered in appearance from largely cystic with extensive hemorrhage to largely solid with su bstantial enhancement after a 2.5-year interval. Renal cancers demonst rated minimal enhancement (11 patients) on early postgadolinium images and were minimally enhanced on delayed images in 10 of 13 tumors, Two renal cancers demonstrated intense enhancement, Renal cancers are wel l shown on MR images in patients with chronic renal insufficiency. Bec ause of the common occurrence of hemorrhage into renal cancers in pati ents with renal insufficiency, caution should be exercised when evalua ting hemorrhagic cystic lesions in these patients.