Assessment of tumor invasion of the vena caval wall in renal cell carcinoma cases by magnetic resonance imaging.
OBJECTIVE
We evaluated the role of magnetic resonance imaging (MRI) in patients with renal cancer and inferior vena caval involvement with reference to its ability to characterize the extent and nature of inferior vena caval tumor extension and wall invasion.


METHODS
The study included 12 consecutive patients with renal cancer and inferior vena caval involvement. All patients underwent imaging on a 1.5 Tesla MRI unit. Coronal, axial T1 and axial T2-weighted images were performed in all cases, while in 6 3-dimensional gadolinium enhanced magnetic resonance angiography and venography were also performed. Images were assessed for the extent and nature of tumor extension, that is tumor versus thrombus, and invasion of the inferior vena caval wall. Imaging results were compared with operative findings.


RESULTS
On MRI the extent and nature of the inferior vena caval tumor was correctly defined in all cases. The sensitivity, specificity and accuracy of inferior vena caval wall invasion were 100%, 89% and 92%, respectively.


CONCLUSIONS
In patients with renal cancer and inferior vena caval involvement MRI defines the tumor level in the inferior vena cava. It is also a sensitive technique for detecting vessel wall invasion and provides important preoperative information for surgical planning.
Aslam Sohaib
S A
SA
Department of Radiology, St. Bartholomew's Hospital and Queen Mary and Westfield College, University of London, London, United Kingdom.
Teh
James
J
Nargund
Vinod H
VH
Lumley
John S P
JS
Hendry
William F
WF
Reznek
Rodney H
RH
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012680:Sensitivity and Specificity; D014682:Vena Cava, Inferior / Q000473:pathology*