Comparison of CT scan and colour flow Doppler ultrasound in detecting venous tumour thrombous in renal cell carcinoma.
BACKGROUND
Renal cell carcinoma has marked tendency to spread into renal vein, inferior vena cava and right side of heart. Extension of tumour thrombus into these veins will alter the surgical approach. We have compared the CT scan with Colour flow Doppler ultrasound in detecting venous tumour thrombus in renal vein and inferior vena cava.


METHODS
This cross-sectional study included 30 adult patients presenting with renal tumour. Patients of either gender were included in the study. Non probability convenience sampling was used. All patients underwent colour flow Doppler ultrasound and CT scan with contrast to asses the renal vein and inferior vena cava. The results were confirmed by intra operative findings and histopathology. The data was analyzed using SPSS version 12.


RESULTS
Out of 30 patients, 20 (66%) were males and 10 (34%) female. The tumour was predominantly on the right side (60%), as was renal venous tumour thrombus (44%). Inferior vena cava was involved in 4 cases predominantly due to right sided tumours. The sensitivity of Doppler ultrasound in detecting renal venous tumour thrombus (88% on right and 100% on left side) was higher than CT scan (63% on right and 60% on left side). Doppler ultrasound was also superior to CT scan in detecting vena caval thrombus.


CONCLUSIONS
The overall sensitivity of Doppler sonography was higher than CT scan in detecting tumour extension into renal veins and inferior vena cava. Therefore, it can be used as a complementary tool in equivocal cases.
Khan
Abdul Rahim
AR
Department of Urology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. arkhan71@hotmail.com
Anwar
Khursheed
K
Fatima
Naheed
N
Khan
Shazia F
SF
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D012082:Renal Veins / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging