الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Multi-phasic contrast enhanced multi detector computed tomography (MDCT) is the golden standard for imaging and characterization of parenchymal renal masses; however, some lesions remain of equivocal nature. When contrast media administration is prohibited, on-contrast study is of little help.
The aim of this work is to determine the role of Multi Detector computed Tomography (MDCT) in characterization of parenchymal renal masses.
This study was conducted on 25 patients with renal lesions varying from solid renal tumors, and complex renal cysts as well. These data was collected in 21 months duration starting from April 2012.
All patients were subjected to:
1. Full history taking.
2. Thorough clinical examination.
3. Laboratory investigations.
4. MDCT.
The final diagnosis was reached by histopathological examination in 17 lesions. In the remaining lesions the diagnoses was based on the consensus of clinical and imaging modalities with follow up and monitoring therapeutic response was done for lesions diagnosed as renal abscesses.
Four cystic lesions were assessed two cases of renal abscesses shows thick enhanced wall on contrast enhanced CT scan and Diagnosis was made by contrast enhanced CT and the relevant clinical history and laboratory finding.
A single case of multi-loculated cystic nephroma, the cyst compressing parenchyma and thin septations the diagnosis achieved by contrast enhanced CT and confirmed by histopathology.
A single case of cystic papillary renal cell carcinoma with solid nodules that enhanced on contrast administration the diagnosis achieved by contrast enhanced CT and confirmed by histopathology
The current study revealed significantly higher pre-contrast attenuation in papillary renal cell carcinoma (PRCC) than other RCC subtypes, High pre-contrast attenuation was also noted in lipid poor AML.
Through multi-phasic MDCT study solid renal masses can be classified according to their enhancement pattern into three groups with significant difference in the degree of enhancement between them at corticomedullary and nephrographic phases:
1. The first group The first group non enhanced lesion (lipoma)
2. The second group showed early enhancement with wash out pattern and includes clear cell renal cell carcinomas (CCRCC),RCC with AML in tuberus sclerosis patient, oncocytomas, lipid rich angiomyolipomas (AML) and chromophobe renal cell carcinoma (CHRCC).
3. The third group included the rest of the solid renal lesions which showed less degree of enhancement with no wash out pattern (prolonged enhancement pattern).