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CT of the Retroperitoneum pp 19–39Cite as

Renal Masses

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Abstract

MDCT is the mainstay in the characterization and staging of renal masses. The examination needs to be performed before and after administration of intravenous contrast material. Pre-contrast images are used for baseline density measurements in both solid and complex cystic masses, but also provide information about morphological and structural features; post-contrast images are used to evaluate contrast-enhancement that do not necessarily indicate malignancy of a renal mass but represents the diagnostic clue that permits to differentiate surgery-needing from non-surgery-needing renal masses. The evaluation of cystic and solid renal masses represents one of the most investigated applications of dual-energy CT technology. Similar to current single-energy CT imaging evaluation of a mass, the virtual unenhanced images can be used to replace the true unenhanced CT acquisition. The attenuation of the lesion on the virtual unenhanced series can serve as a baseline to compare with the contrast-enhanced series. Several studies demonstrated that no significant difference in the attenuation of renal lesions between true and virtual unenhanced images exists. The possibility of omitting the true unenhanced scan permits to achieve a considerable radiation dose saving in renal lesions imaging. Dual-energy color-coded iodine overlay images permit to immediately depict the presence of contrast medium within a mass by means of a color display. The direct visualization of iodine signal within the mass differentiates a cyst from a solid lesion.

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Authors and Affiliations

  1. Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico “G. Martino”, Via Consolare Valeria 1, 98100, Messina, Italy

    Giorgio Ascenti, Achille Mileto, Silvio Mazziotti, Carmelo Sofia & Emanuele Scribano

  2. Siemens AG , Healthcare Sector, Imaging & Therapy Division, Forchheim, Germany

    Bernhard Krauss

Authors
  1. Giorgio Ascenti
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  2. Achille Mileto
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  3. Bernhard Krauss
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  4. Silvio Mazziotti
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  5. Carmelo Sofia
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  6. Emanuele Scribano
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Correspondence to Giorgio Ascenti .

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Ascenti, G., Mileto, A., Krauss, B., Mazziotti, S., Sofia, C., Scribano, E. (2014). Renal Masses . In: CT of the Retroperitoneum. Springer, Milano. https://doi.org/10.1007/978-88-470-5469-1_3

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  • DOI: https://doi.org/10.1007/978-88-470-5469-1_3

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  • Publisher Name: Springer, Milano

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  • Online ISBN: 978-88-470-5469-1

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