Renal cysts: is attenuation artifactually increased on contrast-enhanced CT images?
OBJECTIVE
To determine if the attenuation values of simple renal cysts are artifactually increased on contrast material-enhanced, clinically acquired spiral computed tomographic (CT) images.


METHODS
Dual-phase renal spiral CT studies (5-mm collimation; pitch, 1.0) were retrospectively analyzed in 24 consecutive patients who had ultrasonographic (US) documentation of simple renal cysts. Forty-eight cysts were identified. The attenuation values of each cyst were measured on nonenhanced, cortical phase, and nephrographic phase images. The size and the location of each cyst in relation to the renal parenchyma were also recorded.


RESULTS
The cysts were 0.6-10.8 cm in diameter (mean, 2.6 cm; SD, 2.0). The mean attenuation change in the cysts from nonenhanced to contrast-enhanced images was statistically significant in a comparison of cortical phase and nephrographic phase images (P: <.01): +1.8 HU (SD, 3.8) for cortical phase and +3. 6 HU (SD, 5.6) for nephrographic phase images. Renal cysts 1.0 cm or smaller showed a higher attenuation increase (mean, +4.0 HU for cortical phase and +11.0 HU for nephrographic phase). None of the renal cysts larger than 1.0 cm demonstrated an increase greater than 10 HU (mean, +1.4 HU for cortical phase and +2.3 HU for nephrographic phase). Intraparenchymal cysts showed higher mean attenuation changes than the exophytic cysts.


CONCLUSIONS
Attenuation values in the renal cysts increased artifactually on contrast-enhanced images, but this pseudoenhancement was not substantial and was less than 10 HU when the cyst was larger than 1. 0 cm in diameter.
Bae
K T
KT
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA. baet@mir.wustl.edu
Heiken
J P
JP
Siegel
C L
CL
Bennett
H F
HF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D003287:Contrast Media; D005260:Female; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media