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Published in: European Radiology 2/2018

01-02-2018 | Urogenital

Renal angiomyolipoma without visible fat: Can we make the diagnosis using CT and MRI?

Authors: Robert S. Lim, Trevor A. Flood, Matthew D. F. McInnes, Luke T. Lavallee, Nicola Schieda

Published in: European Radiology | Issue 2/2018

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Abstract

Renal angiomyolipomas without visible fat (AML.wovf) are benign masses that are incidentally discovered mainly in women. AML.wovf are typically homogeneously hyperdense on unenhanced CT without calcification or haemorrhage. Unenhanced CT pixel analysis is not useful for diagnosis. AML.wovf are characteristically homogeneously hypointense on T2-weighted (T2W)-MRI and apparent diffusion coefficient (ADC) maps. Despite early reports, only a minority of AML.wovf show signal intensity drop on chemical-shift MRI due to microscopic fat. AML.wovf most commonly show avid early enhancement with washout kinetics at contrast-enhanced CT and MRI. The combination of homogeneously low T2W and/or ADC signal intensity with avid early enhancement and washout is highly accurate for diagnosis of AML.wovf.

Key Points

AML.wovf are small incidental benign renal masses occurring mainly in women.
AML.wovf are homogeneously hyperdense with low signal on T2W-MRI and ADC map.
AML.wovf typically show avid early enhancement with washout kinetics.
Combining features on CT/MRI is accurate for diagnosis of AML.wovf.
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Metadata
Title
Renal angiomyolipoma without visible fat: Can we make the diagnosis using CT and MRI?
Authors
Robert S. Lim
Trevor A. Flood
Matthew D. F. McInnes
Luke T. Lavallee
Nicola Schieda
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4988-4

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