Renal vein and inferior vena cava involvement in renal adenocarcinoma

This paper demonstrates the effectiveness of GRASS sequences for detecting venous extension of renal cell carcinoma. Forty-five consecutive patients with proved renal cell carcinoma were studied with a 1.5-T system. GRASS sequences were performed in addition to spin-echo T1- and T2-weighted sequences. MR images were evaluated by two reviewers in a blinded fashion. MR findings were subsequently correlated with CT and pathologic findings. GRASS images depicted tumor thrombus in the main renal vein in 13/45 patients and in the inferior vena cava (IVC) in 5/45 patients. There were two false-positive and two false-negative findings for renal vein extensions. Patency of the IVC was correctly assessed in all cases; the cephalic extent of the caval thrombus was correctly delineated in 5/5 cases. In all cases, GRASS sequences were superior to spin-echo MR imaging in evaluation of the extent of tumor invasion