| Abstract [eng] |
Aim of the study: to evaluate the potential of radiological diagnostics in the diagnosis of various histological forms of renal tumours. Objectives: 1. Present the most common radiological imaging techiques used in the diagnosis of renal tumours. 2. To analyse the radiological characteristics of the most common renal tumours and to identify the most typical radiological characteristics of different histological forms of renal tumours using different radiological imaging techniques. 3. Evaluate and present the problems of radiological differential diagnosis of common renal tumours. Methods: A non-systematic search of the scientific literature was carried out in the electronic databases Pubmed, Google Scholar, Pubs RSNA, Elsevier, as well as in the American Journal of Roentgenology, The British Institute of Radiology and World Journal of Radiology article archives. Articles published between 2010 and November 2022 were analysed. The most relevant articles and data summarising the radiological diagnosis of the most common renal tumours were selected for this review and presented in a grouped format according to the histological form of the tumours. In addition, depersonalised CT scans of National Cancer Institute (NCI) patients and ultrasound and magnetic resonance imaging (MRI) images from the scientific literature were analysed and presented. Results: The main radiological imaging techniques in the diagnosis of renal tumours are ultrasound (with and without contrast), computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine. CT with contrast is considered the gold standard, with MRI as an alternative to it. The radiological characteristics depend directly on the internal structure of the tumours. Hypervascular tumours are characterised by intense and rapid contrast accumulation on all radiological examinations, with hyperintense signal usually observed on MRI T2-weighted sequences, whereas hypovascular tumours are characterised by slow and gradual contrast accumulation, with hypointense signal on MRI T2-weighted sequences. Heterogeneous tumour structure is associated with a more aggressive tumour type and worse prognosis. Although these tumours have overlapping features, a basic knowledge of the histological structure of the different histological forms and the typical radiological features helps to better understand and differentiate these tumours from each other. Conclusions: 1. The most common aggressive tumours are clear cell, papillary and chromophobe carcinomas of the inflammatory stroma; the most common benign tumours are angiomyolipoma and oncocytoma. 2. The most important radiological tests in the diagnosis of renal tumours are computed tomography and magnetic resonance imaging. These examinations are complemented by ultrasound with and without contrast and nuclear medicine. 3. The radiological characteristics depend directly on the internal structure of the tumour. Hypervascular tumours are characterised by intense contrast accumulation on various radiological examinations, whereas hypovascular tumours are characterised by moderate to non-intense contrast accumulation. 4. Heterogeneous internal tumour structure is usually associated with an aggressive tumour form and systemic spread, whereas internal heterogeneous structure in benign tumours is due to internal haemorrhage or ischaemia, but is not associated with systemic spread. 5. Radiological differential diagnosis of chromophobe renal cell carcinoma and oncocytoma is usually not possible. |
