title: Evaluating hemorrhage in renal cell carcinoma using susceptibility weighted imaging.
abstract: BACKGROUND
  Intratumoral hemorrhage is a frequent occurrence in renal cell carcinoma and is an indicator of tumor subtype. We hypothesize that susceptibility weighted imaging (SWI) is sensitive to hemorrhage in renal cell carcinoma and can give a more diagnostic image when compared to conventional imaging techniques.
  
  
  METHODS
  A retrospective review of 32 patients with clear cell renal cell carcinoma was evaluated. All patients underwent magnetic resonance imaging (MRI) and 22 out of 32 patients also underwent a computed tomography (CT) scan. Hemorrhage was classified into 3 different categories according to shape and distribution. Histopathology was obtained from all masses by radical nephrectomy. The ability to detect the presence of hemorrhage using CT, non-contrast conventional MRI and SWI was evaluated, and the patterns of hemorrhage were compared.
  
  
  RESULTS
  Using pathologic results as the gold standard, the sensitivities of non-contrast conventional MRI, SWI and CT in detecting hemorrhage in clear cell renal cell carcinoma were 65.6%, 100% and 22.7%, respectively. Accuracy of non-contrast conventional MRI and SWI in evaluating hemorrhagic patterns were 31.3% and 100%, respectively.
  
  
  CONCLUSIONS
  These results demonstrate that SWI can better reveal hemorrhage and characterize the pattern more accurately than either non-contrast conventional MRI or CT. This suggests that SWI is the technique of choice for detecting hemorrhagic lesions in patients with renal cancer.
authors: Department of Radiology, Affiliated Third Hospital of Suzhou University, Changzhou, Jiangsu, China.
authors: Wei
authors: W
authors: Xing
authors: Xiaozhou
authors: X
authors: He
authors: Mohammad A
authors: MA
authors: Kassir
authors: Jie
authors: J
authors: Chen
authors: Jiule
authors: J
authors: Ding
authors: Jun
authors: J
authors: Sun
authors: Jiani
authors: J
authors: Hu
authors: Zishu
authors: Z
authors: Zhang
authors: E Mark
authors: EM
authors: Haacke
authors: Yongming
authors: Y
authors: Dai
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis*; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*