MRA OF RENAL VEINS AND INFERIOR VENA-CAVA FOR STAGING OF RENAL-CELL CARCINOMA

The staging of renal cell carcinoma (RCC) comprises exclusion of tumour expansion into the renal veins and the inferior vena cava (IVC). In 44 patients with RCC these vessels were examined using MRA on the basis of ''time-of-flight'' technique (coronal/axial 2D GE-flash-sequence, MIP-algorithm). The method was evaluated against contrast-enhanced CT and DSA in normal conditions and tumour-involved IVC (n=12) and renal veins (n=32) respectively. Following analysis of projection-angiograms (PA) and individual slices the results of MRA without contrast material included an information on vascular tumour extension that was identically safe as CT and DSA. In coronal slice orientation tumour extension into the vena cava was proven in 100%, and into the renal veins in 84%. Additional axial slices were necessary to demonstrate tumour extension into the renal veins in unclear cases. Single slices showed to be superior to PA for a correct identification of the size of the tumour thrombus.